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Organization
MEDICAL STATE OF QUEENS
Active
Organization
MEDICAL STATE OF QUEENS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NIKOLAI LAGODUKE (DR)
(718) 554-1150
Entity
Organization
Contact information
Practice address
8544 66TH RD, REGO PARK, NY 11374-5212
(718) 565-6050
Mailing address
8544 66TH RD, REGO PARK, NY 11374-5212
(718) 565-6050
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
233906
NY
Other
Enumeration date
04/30/2014
Last updated
10/15/2015
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