Individual
LILIT GEVORGYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
111 E 210TH ST, BRONX, NY 10467-2401
(718) 920-4321
Mailing address
7039 WORTSER AVE, NORTH HOLLYWOOD, CA 91605-4811
(323) 283-1987
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
53510
CA
363AS0400X
Surgical Physician Assistant
Primary
021058-1
NY
Other
Enumeration date
09/20/2016
Last updated
07/21/2022
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