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1386367142
NIKOL ILYASOV
GREENVALE, NY
NPI
1386367142
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
Enumeration Date
2022-09-26
Last Update Date
2023-06-12
Business Address
NIKOL ILYASOV PA-C
2200 NORTHERN BLVD
GREENVALE, NY 11548-1219
Phone number: 877-896-9301
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Mailing Address
NIKOL ILYASOV PA-C
2200 NORTHERN BOULVARD SUITE 150
GREENVALE, NY 11548
Phone number: 877-896-9301
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