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Organization
MAZUROV MEDICAL PC
Active
Organization
MAZUROV MEDICAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BORIS MAZUROV MD (OWNER)
(718) 966-1738
Entity
Organization
Contact information
Practice address
505 JEFFERSON BLVD, STATEN ISLAND, NY 10312-2225
(718) 966-1738
Mailing address
505 JEFFERSON BLVD, STATEN ISLAND, NY 10312-2225
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
210722-1
NY
Other
Enumeration date
07/19/2011
Last updated
07/19/2011
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