CARLO IVAN GWARDSCHALADSE

HAWTHORNE, NY
NPI1386639441
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: NY  005375)
Enumeration Date2005-09-15
Last Update Date2008-05-05
Business Address
-- CARLO IVAN GWARDSCHALADSE PA
19 BRADHURST AVE
HAWTHORNE, NY 10532-2139
Phone number: 914-345-0162
Mailing Address
-- CARLO IVAN GWARDSCHALADSE PA
95 GRASSLANDS RD MUNGER PAVILION
VALHALLA, NY 10595-1652
Phone number: 914-493-7621
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