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1265948020
LIORA POLVANOV
MELVILLE, NY
NPI
1265948020
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
174400000X Specialist
Additional Taxonomies
106S00000X Behavior Technician
Enumeration Date
2017-12-15
Last Update Date
2019-03-01
Business Address
LIORA POLVANOV
225 BROADHOLLOW RD
MELVILLE, NY 11747-4822
Phone number: 631-385-7780
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Mailing Address
LIORA POLVANOV
7000 AUSTIN ST
FOREST HILLS, NY 11375-1022
Phone number:
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