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1881920502
IRINA ILYASOV
BROOKLYN, NY
NPI
1881920502
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: NY 013442)
Enumeration Date
2009-10-30
Last Update Date
2009-10-30
Business Address
-- IRINA ILYASOV RPA-C
8686 BAY PKWY STE M4
BROOKLYN, NY 11214-5103
Phone number: 718-265-7700
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Mailing Address
-- IRINA ILYASOV RPA-C
62 KEUNE CT
STATEN ISLAND, NY 10304-1431
Phone number: 718-265-7700
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