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1114274776
GENNADI JOSOVICH
MERRICK, NY
NPI
1114274776
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
174400000X Specialist
(Licence: NY 249441031)
Enumeration Date
2012-08-13
Last Update Date
2012-08-13
Business Address
-- GENNADI JOSOVICH
2068 BERKLEY LN
MERRICK, NY 11566-5514
Phone number: 917-642-0644
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Mailing Address
-- GENNADI JOSOVICH
2068 BERKLEY LN
MERRICK, NY 11566-5514
Phone number: 917-642-0644
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