Individual
AYUKO IVERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
17 E 102ND ST, NEW YORK, NY 10029-5204
(212) 659-8551
(212) 831-8116
Mailing address
150 E 42ND ST FL 9, NEW YORK, NY 10017-5699
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
291502
NY
207SG0201X
Clinical Genetics (M.D.) Physician
Primary
291502
NY
Other
Enumeration date
03/23/2015
Last updated
09/11/2019
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