Individual provider · Type 1 NPI
Ilyas Liventsov, ACNPC-AG
Acute Care Nurse Practitioner · Syracuse, NY
NPI number
1760153985
Active
Practice location
750 E Adams St
Syracuse, NY 13210-2306
Mailing address
750 E Adams St Fl 8
Syracuse, NY 13210-2306
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Acute Care Nurse Practitioner | 363LA2100X | 432158 (NY) |
| Acute Care Nurse Practitioner Primary | 363LA2100X | F432158 (NY) |
Acute Care Nurse Practitioner: Definition to come...
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About NPI 1760153985
Ilyas Liventsov, ACNPC-AG's National Provider Identifier is 1760153985, issued on Sep 27, 2021. The primary taxonomy on file is Acute Care Nurse Practitioner (363LA2100X), and the practice location is in Syracuse, NY. The record was last updated on Sep 27, 2021.