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General NPI Number Information
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NPI Number | 1255953519
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Entity Type | Individual
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Provider Name | ILANA VOSK MS, PA-CR
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Gender | Female
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Dates
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Enumeration Date | 05/09/2020
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Last Update Date | 08/01/2020
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Provider Practice Location Address
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Address Line | 1 DAKOTA DR STE 320
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City | NEW HYDE PARK
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State | NY
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Zip | 11042-1136
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Country | US
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Telephone | 355-051-6608
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Fax |
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Provider Business Mailing Address
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Address Line | 412 ADAMS AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10306-5238
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Country | US
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Telephone | 718-200-7730
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 025321
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License Number State | NY
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