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1316067390
DIANA GAVRILOV
NEW HYDE PARK, NY
NPI
1316067390
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: NY 006024)
Enumeration Date
2007-03-31
Last Update Date
2007-07-08
Business Address
-- DIANA GAVRILOV PA
27005 76TH AVE
NEW HYDE PARK, NY 11040-1433
Phone number: 718-470-7331
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Mailing Address
-- DIANA GAVRILOV PA
972 BRUSH HOLLOW RD
WESTBURY, NY 11590-1740
Phone number: 516-876-5555
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