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1578159422
ODE EGHAREVBA
ASTORIA, NY
NPI
1578159422
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: NY 046800)
Enumeration Date
2020-12-15
Last Update Date
2021-06-14
Business Address
ODE EGHAREVBA PT, DPT
2747 CRESCENT ST STE 203
ASTORIA, NY 11102-3142
Phone number: 347-869-9798
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Mailing Address
ODE EGHAREVBA PT, DPT
100 BROADWAY UNIT 594
LYNBROOK, NY 11563-5013
Phone number: 347-869-9798
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