Individual
ANDRIY ILASHUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APN
Contact information
Practice address
9225 KENNEDY BLVD #A, NORTH BERGEN, NJ 07047
(201) 869-2707
Mailing address
24 KOENIG CT, FAIR LAWN, NJ 07410-2743
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
26NJ00631000
NJ
Other
Enumeration date
05/05/2016
Last updated
05/05/2016
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