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1104308998
DIANA GAVRILOVA
JAMAICA, NY
NPI
1104308998
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
Enumeration Date
2018-08-29
Last Update Date
2018-08-29
Business Address
Ms. DIANA GAVRILOVA PA-C
8268 164TH ST
JAMAICA, NY 11432-1121
Phone number: 718-883-3070
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Mailing Address
Ms. DIANA GAVRILOVA PA-C
8268 164TH ST
JAMAICA, NY 11432-1121
Phone number:
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