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Individual
GEORGIY YEGIAZAROV
Active
Individual
GEORGIY YEGIAZAROV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
022633
NY
363A00000X
Physician Assistant
—
—
Other
Enumeration date
09/21/2018
Last updated
06/23/2023
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