Alisa Sidorov
Alisa Sidorov is an Early Intervention Provider Agency in Staten Island, New York. Practices as a sole proprietor. Licensed in New York.
- Licensed in
- NY
- In the registry since
- 2015
Practice location Address checks out
21 Palisade StStaten Island, NY 10305-4711
Phone: (646) 234-6025
Fax: (718) 273-0324
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Early Intervention Provider Agency (primary) | Taxonomy 252Y00000X · Licence 1296222 (NY) |
|---|
Record details
| NPI number | 1629460829 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | Yes |
| NPI enumerated | February 24, 2015 |
| Last updated in NPPES | February 24, 2015 |
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