Organization
PARK EAST NP IN PSYCHIATRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ILANA KHONONOV NP (OWNER)
(347) 415-0774
Entity
Organization
Contact information
Practice address
1735 YORK AVE APT 29E, NEW YORK, NY 10128-6861
(347) 415-0774
Mailing address
1735 YORK AVE APT 29E, NEW YORK, NY 10128-6861
(347) 415-0774
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
12/20/2023
Last updated
12/20/2023
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