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Individual

DIANA AVSKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
101 NICOLLS RD, STONY BROOK, NY 11794-0001
(631) 444-8329
Mailing address
101 NICOLLS RD # T18-040, STONY BROOK, NY 11794-8191

Taxonomy

Speciality
Code
Description
License number
State
2086S0127X
Trauma Surgery Physician
Primary
319399-01
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
319339
NEW YORK STATE LICENSE
NY
01
LL2803
NEVADA STATE LICENSE
Enumeration date
04/29/2016
Last updated
10/21/2022
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