Individual
ALEXANDER SVETLOSANOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
20514 LINDEN BLVD STE 204, SAINT ALBANS, NY 11412-2934
(718) 528-5493
(718) 525-4305
Mailing address
1581 E 24TH ST APT 2C, BROOKLYN, NY 11229-1664
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
660170-1
NY
Other
Enumeration date
09/11/2012
Last updated
09/11/2012
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