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1093074254
YEFIM KHAYDATOV
SOUTH OZONE PARK, NY
NPI
1093074254
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225X00000X Occupational Therapist
(Licence: NY 63 017225)
Enumeration Date
2012-05-09
Last Update Date
2012-05-09
Business Address
-- YEFIM KHAYDATOV OT
10810 109TH AVE
SOUTH OZONE PARK, NY 11420-1005
Phone number: 718-641-4956
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Mailing Address
-- YEFIM KHAYDATOV OT
10810 109TH AVENUE
SOUTH OZONE PARK, NY 11420
Phone number: 718-641-4956
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