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1376820621
ROUSLANA REVITSKAIA
MINEOLA, NY
NPI
1376820621
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LA2200X Nurse Practitioner Adult Health
(Licence: NY F305810-1)
Enumeration Date
2011-11-14
Last Update Date
2011-11-14
Business Address
ROUSLANA REVITSKAIA ANP - BC
259 1ST ST
MINEOLA, NY 11501-3957
Phone number: 516-663-0333
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Mailing Address
ROUSLANA REVITSKAIA ANP - BC
259 1ST ST
MINEOLA, NY 11501-3957
Phone number:
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