Most Relevant Information
Provider Data
| NPI Number: | 1003219635 |
| Provider Name: | IRENA ISRAILOVA MS GEN AND SPEC ED |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: | 3568882 |
Most Important Dates
| Enumeration Date: | 09/26/2014 |
| Last Updated: | 09/26/2014 |
Provider Practice Location
6120 GRAND CENTRAL PKWY
B1102
FOREST HILLS
NY
113751263
Practice Location Phone/Fax
| Phone: | 6464207735 |
| Fax: |
Provider Mailing Location
6120 GRAND CENTRAL PKWY
B1102
FOREST HILLS
NY
113751263
Provider Mailing Phone/Fax
| Phone: | 6464207735 |
| Fax: |