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NPI Code Detail

MEDICARE: SIANNA DIMITROVA

MEDICARE:   SIANNA  DIMITROVA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist014795-1NY

General Provider Information

NPI Number : 1457595514
Entity Type Code : Individual
Provider Name (Legal Business Name) : SIANNA DIMITROVA
Provider Business Mailing Address
First Line : 2022 BERGEN AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11234-6218
Country : US
Telephone Number : 718-531-4784
Fax Number :
Provider Business Practice Location Address
First Line : 2022 BERGEN AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11234-6218
Country : US
Telephone Number : 718-531-4784
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/20/2009
Last Update Date : 04/20/2009

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Directions to “ SIANNA DIMITROVA ” Practice Location

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