Individual
YELENA SHALOMOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
8232 166TH ST, JAMAICA, NY 11432-1218
(718) 591-5942
Mailing address
8232 166TH ST, JAMAICA, NY 11432-1218
(718) 591-5942
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
006368
NY
Other
Enumeration date
03/22/2017
Last updated
03/22/2017
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