Diana Ilyasova O.D.

NPI 1629302658 - Optometrist - 152W00000X

NPI Details
NPI 1629302658
Gender Female
Enumeration Date 09/23/2009
Last Updated 09/12/2011
Entity Type Individual
Active Over 7 years ago
Practice Location
714 BEACH 20TH ST
FAR ROCKAWAY NY, 11691-3502, US
Phone (718) 327-7457
Fax
Business Location
7511 169TH ST
FRESH MEADOWS NY, 11366-1337, US
Phone
Fax
Toxanomy
Taxonomy Code 152W00000X
License State New York
License Number TUV007417
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According to our database, Dr. Diana Ilyasova O.D. NPI is 1629302658, taxonomy code is 152W00000X and license number is TUV007417, license state is located at New York. Diana Ilyasova O.D. physically located at 714 Beach 20th St, Far Rockaway NY, 11691-3502. NPI Number Diana Ilyasova O.D. has the Individual type.

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1629302658 NPI number is provided on an as is basis without warranty of any kind. 1629302658 is maintained by the National Plan & Provider Enumeration System. The contents of Diana Ilyasova O.D. are for informational purposes only.