Individual
MRS. AYLAR ANSARITALESH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
16600 CENTERFIELD DR, EAGLE RIVER, AK 99577-7702
(907) 202-9238
Mailing address
16600 CENTERFIELD DR STE 205, EAGLE RIVER, AK 99577-7702
(907) 202-9238
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2021029347
MO
363A00000X
Physician Assistant
Primary
246215
AK
363A00000X
Physician Assistant
5470
WI
363A00000X
Physician Assistant
MA063850
PA
363A00000X
Physician Assistant
MA7450858
AK
Other
Enumeration date
10/01/2019
Last updated
03/30/2026
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