Individual
DIANA AVIZOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
6961 185TH ST, FRESH MEADOWS, NY 11365-3513
(917) 756-2105
Mailing address
6961 185TH ST, FRESH MEADOWS, NY 11365-3513
(917) 756-2105
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
355318
NY
Other
Enumeration date
10/15/2024
Last updated
10/15/2024
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