Individual
ALLA VASSERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2934 BRIGHTON 4TH ST, APT 5, BROOKLYN, NY 11235-8527
(347) 476-4256
Mailing address
2934 BRIGHTON 4 STR, APT 5, BROOKLYN, NY 11235
(347) 476-4256
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
684403
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102471064
—
NY
Enumeration date
09/29/2015
Last updated
09/29/2015
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