Individual
ORTAL ISRAILOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
8287 164TH PL, JAMAICA, NY 11432-1824
(347) 656-4270
Mailing address
8287 164TH PL, JAMAICA, NY 11432-1824
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
856579
NY
363L00000X
Nurse Practitioner
Primary
F360140
NY
Other
Enumeration date
06/13/2023
Last updated
08/06/2026
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