IGOR LIZOGUBENKO

PORT JEFFERSON, NY
NPI1033163035
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: NY  008125-1)
Enumeration Date2006-05-22
Last Update Date2008-01-16
Business Address
-- IGOR LIZOGUBENKO P.A.
200 BELLE TERRE RD
PORT JEFFERSON, NY 11777-1928
Phone number: 631-474-6000
Mailing Address
-- IGOR LIZOGUBENKO P.A.
PO BOX 826207
PHILADELPHIA, PA 19182-6207
Phone number: 800-377-8721
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