Fetisov, Anton

Fetisov, Anton is an sole proprietor health care provider with primary practice located at 31 Kingston Ave , South Floral Park NY 11001-3517. He recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist, Nursing Service Providers / Registered Nurse. Nursing Service Providers / Registered Nurse is his primary health care specialty. Fetisov, Anton can be contacted via phone (929) 928-0468.

Contact Information

Primary practice address
31 Kingston Ave South Floral Park NY 11001-3517
Phone: (929) 928-0468
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Massage Therapist 225700000X 033053 New York
Nursing Service Providers / Registered Nurse 163W00000X 978345 New York

Profile Details

NPI number 1811698665
LBN Legal business name Fetisov, Anton
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 16th, 2023
Last updated Jun 9th, 2025 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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