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General NPI Number Information
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NPI Number | 1700410701
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Entity Type | Individual
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Provider Name | JONATHAN AKILOV PA
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Gender | Male
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Dates
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Enumeration Date | 02/27/2020
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Last Update Date | 02/27/2020
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Provider Practice Location Address
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Address Line | 1000 N VILLAGE AVE
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City | ROCKVILLE CENTRE
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State | NY
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Zip | 11570-1000
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Country | US
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Telephone | 516-705-2525
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Fax |
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Provider Business Mailing Address
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Address Line | 8516 63RD DR APT 2
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City | REGO PARK
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State | NY
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Zip | 11374-4852
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Country | US
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Telephone | 347-488-8946
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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 |
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License Number State |
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