Individual
ANASTASIA KIRILLOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSED
Contact information
Practice address
38 GOODALL ST, STATEN ISLAND, NY 10308-3396
(718) 288-4488
Mailing address
38 GOODALL ST, STATEN ISLAND, NY 10308-3396
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
3136154
NY
Other
Enumeration date
11/20/2024
Last updated
11/20/2024
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