Individual
ANNA DYAKOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
100 PARK ST, GLENS FALLS HOSPITAL, GLENS FALLS, NY 12801-4413
(518) 926-5918
(518) 926-5917
Mailing address
PO BOX 304, GLENS FALLS, NY 12801-0304
(518) 926-5918
(518) 926-5917
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
015191
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03421134
—
NY
Enumeration date
02/02/2012
Last updated
12/11/2013
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