LARISA MALISOVA

STATEN ISLAND, NY
NPI1861448896
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy208D00000X General Practice
(Licence: NY  234484)
Enumeration Date2006-05-25
Last Update Date2010-05-28
Business Address
-- LARISA MALISOVA DO
420 LYNDALE AVE
STATEN ISLAND, NY 10312-6131
Phone number: 718-967-5630
Mailing Address
-- LARISA MALISOVA DO
1270 E 19TH ST APT. 6 M
BROOKLYN, NY 11230-5457
Phone number: 718-338-0164
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