Individual
DMITRIY MALYSHEV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTA
Contact information
Practice address
6612 102ND ST APT 5C, REGO PARK, NY 11374-4528
(718) 909-2375
Mailing address
6612 102ND ST APT 5C, REGO PARK, NY 11374-4528
(718) 909-2375
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
007206
NY
Other
Enumeration date
04/22/2009
Last updated
04/22/2009
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