Abo Suyonov, PA
Physician Assistant in Mineola, NY. Individual provider (NPI-1).
NPI number1881865533
StatusActive
Last updated in NPPESNov 3, 2017
Details
- NPI
- 1881865533
- Entity type
- Individual (NPI-1)
- Name
- Mr. Abo Suyonov
- Credential
- PA
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Mar 20, 2008
- Last updated
- Nov 3, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 011213 | NY | Yes |
| 363A00000X | Physician Assistant | 5601008481 | MI |
Practice location
700 Hickville Road259 1st Street
Mineola, NY 11501
Phone 516-663-8312 · Fax 516-663-2184
Mailing address
700 Hicksville RdSuite 204
Bethpage, NY 11714-3471
Phone 516-576-6106 · Fax 516-576-5801
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