Individual
MS. ANI MOTSONELIDZE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
2510 30TH AVE, ASTORIA, NY 11102-2418
(718) 932-1000
Mailing address
7 CORBIN PL # 3B, BROOKLYN, NY 11235-4801
(917) 745-6469
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
026155
NY
Other
Enumeration date
03/11/2021
Last updated
05/07/2023
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