Individual
VIOLETA IZRAILOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
7529 187TH ST, FRESH MEADOWS, NY 11366-1725
(917) 579-7776
Mailing address
7529 187TH ST, FRESH MEADOWS, NY 11366-1725
(917) 579-7776
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
F309530
NY
Other
Enumeration date
11/02/2020
Last updated
11/02/2020
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