SearchNew York163W00000X

Izrael Polvanov, RN

NPI 1831824523 · on the registry since 2022 · sole proprietor

Practice

Address
3425 Vernon Blvd
Astoria, NY 11106
Phone
(877) 889-0836
Clinicians at this address
4

Registry record

Primary taxonomy
163W00000X
163W00000X
Licence states on file
NY
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2022-07-18

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in New York