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General NPI Number Information
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NPI Number | 1215894555
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Entity Type | Individual
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Provider Name | GUENADI MOLTCHANOV
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Gender | Male
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Dates
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Enumeration Date | 01/08/2026
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Last Update Date | 01/08/2026
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Provider Practice Location Address
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Address Line | 247 W 46TH ST APT 1804
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City | NEW YORK
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State | NY
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Zip | 10036-1464
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Country | US
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Telephone | 718-377-5000
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Fax | 718-377-5002
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Provider Business Mailing Address
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Address Line | 247 W 46TH ST APT 1804
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City | NEW YORK
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State | NY
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Zip | 10036-1464
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Country | US
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Telephone | 718-377-5000
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Fax | 718-377-5002
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 011512
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License Number State | NY
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