| Ilia Gerassimov, LMT | |
|
14 Center St, Little Ferry, NJ 07643-1803 | |
| (718) 506-4515 | |
| Not Available |
| Full Name | Ilia Gerassimov |
|---|---|
| Gender | Male |
| Speciality | Massage Therapist |
| Location | 14 Center St, Little Ferry, New Jersey |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285211961 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225700000X | Massage Therapist | 024648 (New York) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Ilia Gerassimov, LMT 14 Center St, Little Ferry, NJ 07643-1803 Ph: (718) 506-4515 | Ilia Gerassimov, LMT 14 Center St, Little Ferry, NJ 07643-1803 Ph: (718) 506-4515 |
Ms. Sandra Sungju Park, Massage Therapist Medicare: Not Enrolled in Medicare Practice Location: 103 Waterside Dr, Little Ferry, NJ 07643 Phone: 201-741-7578 | |
Kesjana Divjaka, LMT, CDT, MLD-C Massage Therapist Medicare: Not Enrolled in Medicare Practice Location: 269 Us Highway 46 Ste 128, Little Ferry, NJ 07643 Phone: 551-352-8695 |