Individual
ALEXANDER CYRIL IVANOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
525 E 68TH ST # 124, NEW YORK, NY 10065-4870
(212) 746-2941
Mailing address
1516 FRANKLIN AVE, RIVER FOREST, IL 60305-1043
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/24/2024
Last updated
04/24/2024
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