Ilia Gerassimov, LMT

NPI #1285211961 in Little Ferry, New Jersey

Provider Information

NPI Number: 1285211961
Entity Type: Individual
Name: Ilia Gerassimov, LMT
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Massage Therapist
Credential: LMT
Enumeration Date: Mar 27, 2021
Last Updated: Mar 27, 2021

Practice Location

Address: 14 CENTER ST
City: Little Ferry
State: New Jersey
ZIP Code: 07643-1803
Phone: (718) 506-4515

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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