Organization
IZABELLA DYAKOVETSKY MD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IZABELLA DYAKOVETSKY MD (PRESEDENT)
(215) 322-9020
Entity
Organization
Contact information
Practice address
201 LAKESIDE PARK, STE B, SOUTHAMPTON, PA 18966-4049
(215) 322-9020
(215) 322-9040
Mailing address
201 LAKESIDE PARK, STE B, SOUTHAMPTON, PA 18966-4049
(215) 322-9020
(215) 322-9040
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
06/17/2008
Last updated
06/17/2008
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