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1396061032
ELANA YUSUPOVA
JAMAICA, NY
NPI
1396061032
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363AS0400X Physician Assistant, Surgical
(Licence: NY 013981)
Enumeration Date
2010-04-19
Last Update Date
2010-04-19
Business Address
-- ELANA YUSUPOVA P.A.
8311 139TH ST APT 1H
JAMAICA, NY 11435-1602
Phone number: 917-209-5745
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Mailing Address
-- ELANA YUSUPOVA P.A.
8311 139TH ST APT 1H
JAMAICA, NY 11435-1602
Phone number: 917-209-5745
Copy
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