Individual provider · Type 1 NPI
Diana Gavrilov, PA
Medical Physician Assistant · New Hyde Park, NY
NPI number
1316067390
Active
Practice location
27005 76th Ave
New Hyde Park, NY 11040-1433
Mailing address
972 Brush Hollow Rd
Westbury, NY 11590-1740
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | 006024 (NY) |
Medical Physician Assistant: Definition to come...
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About NPI 1316067390
Diana Gavrilov, PA's National Provider Identifier is 1316067390, issued on Mar 31, 2007. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in New Hyde Park, NY. The record was last updated on Jul 8, 2007.