Provider Demographics
NPI:1659675320
Name:IZRAILOVA, ANZHELA (FNP)
Entity type:Individual
Prefix:
First Name:ANZHELA
Middle Name:
Last Name:IZRAILOVA
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 1:6536 110TH ST
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-1845
Mailing Address - Country:US
Mailing Address - Phone:646-691-4353
Mailing Address - Fax:
Practice Address - Street 1:5 E 98TH ST FL 6
Practice Address - Street 2:DEPARTMENT OF ANESTHESIA
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6501
Practice Address - Country:US
Practice Address - Phone:212-241-8916
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-10
Last Update Date:2011-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY33 336053363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily