Individual
DIANA D. IVEZAJ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
100 PORT WASHINGTON BLVD, ROSLYN, NY 11576-1347
(516) 365-4888
Mailing address
100 PORT WASHINGTON BLVD STE G05, ROSLYN, NY 11576-1347
(516) 365-4888
(516) 365-4820
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
348243
NY
Other
Enumeration date
09/18/2021
Last updated
08/04/2022
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