Igor Lizogubenko P.A.

NPI 1033163035 - Physician Assistant - 363A00000X

NPI Details
NPI 1033163035
Gender Male
Enumeration Date 05/22/2006
Last Updated 01/16/2008
Entity Type Individual
Active Over 10 years ago
Practice Location
200 BELLE TERRE RD
PORT JEFFERSON NY, 11777-1928, US
Phone (631) 474-6000
Fax
Business Location
PO BOX 826207
PHILADELPHIA PA, 19182-6207, US
Phone (800) 377-8721
Fax (304) 523-2241
Toxanomy
Taxonomy Code 363A00000X
License State New York
License Number 008125-1
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According to our database, Igor Lizogubenko P.A. NPI is 1033163035, taxonomy code is 363A00000X and license number is 008125-1, license state is located at New York. Igor Lizogubenko P.A. physically located at 200 Belle Terre Rd, Port Jefferson NY, 11777-1928. NPI Number Igor Lizogubenko P.A. has the Individual type.

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1033163035 NPI number is provided on an as is basis without warranty of any kind. 1033163035 is maintained by the National Plan & Provider Enumeration System. The contents of Igor Lizogubenko P.A. are for informational purposes only.