ALISA SIDOROV

STATEN ISLAND, NY
NPI1629460829
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy252Y00000X Early Intervention Provider Agency
(Licence: NY  1296222)
Enumeration Date2015-02-24
Last Update Date2015-02-24
Business Address
-- ALISA SIDOROV
21 PALISADE ST
STATEN ISLAND, NY 10305-4711
Phone number: 646-234-6025
Mailing Address
-- ALISA SIDOROV
21 PALISADE ST
STATEN ISLAND, NY 10305-4711
Phone number: 646-234-6025
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