Stanislav Fomin

NPI #1154799609 in Newtown, Pennsylvania

Provider Information

NPI Number: 1154799609
Entity Type: Individual
Name: Stanislav Fomin
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Occupational Therapist
Enumeration Date: Sep 14, 2015
Last Updated: Sep 14, 2015

Practice Location

Address: 70 DURHAM RD
City: Newtown
State: Pennsylvania
ZIP Code: 18940-1303
Phone: (215) 710-0557

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapist	225X00000X	Primary

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