Individual
DINA BLYASHUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3094 LOWER MOUNTAIN RD, SANBORN, NY 14132-9109
(716) 909-6612
Mailing address
3094 LOWER MOUNTAIN RD, SANBORN, NY 14132-9109
(716) 909-6612
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
007633-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007633-1
PTA
NY
Enumeration date
05/01/2015
Last updated
05/01/2015
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