IZRAEL POLVANOV

ASTORIA, NY
NPI1831824523
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy163W00000X Registered Nurse
(Licence: NY  770613)
Enumeration Date2022-07-18
Last Update Date2022-07-18
Business Address
IZRAEL POLVANOV RN
3425 VERNON BLVD
ASTORIA, NY 11106-5121
Phone number: 877-889-0836
Mailing Address
IZRAEL POLVANOV RN
6837 YELLOWSTONE BLVD APT D42
FOREST HILLS, NY 11375-3413
Phone number: 718-541-0852
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