Provider Demographics
NPI:1205606324
Name:IV EVOLUTION MEDICAL PLLC
Entity type:Organization
Organization Name:IV EVOLUTION MEDICAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:BEVERLY
Authorized Official - Middle Name:MARION
Authorized Official - Last Name:KRASZEWSKI-SILVERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:516-273-1448
Mailing Address - Street 1:65 BERRY HILL RD
Mailing Address - Street 2:
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-2624
Mailing Address - Country:US
Mailing Address - Phone:917-434-2102
Mailing Address - Fax:
Practice Address - Street 1:65 BERRY HILL RD
Practice Address - Street 2:
Practice Address - City:SYOSSET
Practice Address - State:NY
Practice Address - Zip Code:11791-2624
Practice Address - Country:US
Practice Address - Phone:516-273-1448
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-09
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty