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1790026011
YURIY OLEGOVICH IVANOV
MANHASSET, NY
NPI
1790026011
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2081P2900X Physical Medicine & Rehabilitation, Pain Medicine
(Licence: NY 276396)
Enumeration Date
2013-03-12
Last Update Date
2022-06-26
Business Address
YURIY OLEGOVICH IVANOV DO
1554 NORTHERN BLVD BLDG FLOOR4
MANHASSET, NY 11030-3053
Phone number: 516-321-6410
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Mailing Address
YURIY OLEGOVICH IVANOV DO
1554 NORTHERN BLVD FL 4
MANHASSET, NY 11030-3053
Phone number: 516-321-6410
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