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SERGUEI JOURAVLEV

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
111 E 210TH ST, BRONX, NY 10467-2401
(718) 920-8379
Mailing address
61 ROSLYN DR, GLEN HEAD, NY 11545-1733
(704) 779-7350

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
022472
NY

Other

Enumeration date
08/21/2018
Last updated
08/21/2018
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