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Individual

MS. LARISA KNOPOVA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ANP-BC, MSN

Contact information

Practice address
475 SEAVIEW AVE, STATEN ISLAND, NY 10305-3436
(718) 226-1988
(718) 226-1970
Mailing address
475 SEAVIEW AVE, STATEN ISLAND, NY 10305-3436
(718) 226-1988
(718) 226-1970

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
501651
NY
363LA2200X
Adult Health Nurse Practitioner
Primary
F303803
NY

Other

Enumeration date
01/05/2008
Last updated
09/19/2013
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