Individual
AUGUSTINE GNALIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2510 30TH AVE, ASTORIA, NY 11102-2418
(718) 932-1000
Mailing address
2510 30TH AVE, ASTORIA, NY 11102-2448
(718) 932-1000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
026096
NY
Other
Enumeration date
12/27/2020
Last updated
07/13/2021
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