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1699393579
IRMA DIASAMIDZE
NEW HYDE PARK, NY
NPI
1699393579
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: NY 345624)
Enumeration Date
2020-07-08
Last Update Date
2020-07-08
Business Address
IRMA DIASAMIDZE
3000 MARCUS AVE STE 2W15
NEW HYDE PARK, NY 11042-1005
Phone number: 855-201-4988
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Mailing Address
IRMA DIASAMIDZE
2550 INDEPENDENCE AVE APT 5H
BRONX, NY 10463-6255
Phone number:
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