Individual
ANATOLIY VERNIKOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1463 OCEAN AVE, BROOKLYN, NY 11230-3978
(917) 624-4040
Mailing address
1463 OCEAN AVE, BROOKLYN, NY 11230-3978
(917) 624-4040
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
302471-1
NY
Other
Enumeration date
10/09/2018
Last updated
10/09/2018
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