Individual provider · Type 1 NPI

Mishell Israilov

Specialist · Rockaway Park, NY

NPI number 1205614005 Active

Practice location

11506 Rockaway Beach Blvd
Rockaway Park, NY 11694-2346

Call (718) 554-7766 Map

Mailing address

40 Richard Rd
East Norwich, NY 11732-1233

Specialties and licenses

TaxonomyCodeLicense
Specialist Primary 174400000XNone listed

Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

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About NPI 1205614005

Mishell Israilov's National Provider Identifier is 1205614005, issued on Sep 21, 2023. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Rockaway Park, NY. The record was last updated on Sep 21, 2023.