Individual
ANNA IVANOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
270-05 76TH AVENUE, NEW HYDE PARK, NY 11040
(718) 470-7500
Mailing address
1 BROOKDALE PLZ, BROOKLYN, NY 11212-3139
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
330317
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/26/2016
Last updated
02/03/2025
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