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1659908960
ALISA KHOMUTOVA
STONY BROOK, NY
NPI
1659908960
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2020-03-25
Last Update Date
2020-03-25
Business Address
ALISA KHOMUTOVA
HSC LEVEL 19 ROOM 030
STONY BROOK, NY 11794-0001
Phone number: 631-444-1791
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Mailing Address
ALISA KHOMUTOVA
HEALTH SCIENCE TOWER LEVEL 19, ROOM 030
STONY BROOK, NY 11794-0001
Phone number: 818-212-9962
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