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Organization
CORONA ING INC
Active
Organization
CORONA ING INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROZA BAGDASAROVA (OWNER)
(718) 406-9032
Entity
Organization
Contact information
Practice address
3719 108TH ST, CORONA, NY 11368-4176
(718) 406-9032
(917) 745-1561
Mailing address
3719 108TH ST, CORONA, NY 11368-4176
(718) 406-9032
(917) 745-1561
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
—
NULL
305S00000X
Point of Service
—
NULL
405300000X
Prevention Professional
—
NULL
405300000X
Prevention Professional
—
—
Other
Enumeration date
12/02/2021
Last updated
02/02/2022
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