Individual
DMITRI PETRIASHVILI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1914 W 5TH ST APT 1F, BROOKLYN, NY 11223-2614
(347) 681-5507
Mailing address
1914 W 5TH ST APT 1F, BROOKLYN, NY 11223-2614
(347) 681-5507
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
011306-1
NY
Other
Enumeration date
12/07/2018
Last updated
12/07/2018
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