Provider Demographics
NPI:1013466184
Name:ISRAILOVA, EVA (FNP)
Entity Type:Individual
Prefix:
First Name:EVA
Middle Name:
Last Name:ISRAILOVA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2784 CONEY ISLAND AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-5022
Mailing Address - Country:US
Mailing Address - Phone:718-368-4000
Mailing Address - Fax:718-368-4001
Practice Address - Street 1:2784 CONEY ISLAND AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-5022
Practice Address - Country:US
Practice Address - Phone:917-642-2243
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-29
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF346779-01363LF0000X
NY2268L001374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No374U00000XNursing Service Related ProvidersHome Health Aide