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Organization
MNB MEDICAL PC
Active
Organization
MNB MEDICAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAZOLTUV BORUKHOVA M.D. (DIRECTOR)
(718) 902-1958
Entity
Organization
Contact information
Practice address
6442 108TH ST, FOREST HILLS, NY 11375-1611
(718) 902-1958
(718) 459-2222
Mailing address
6442 108TH ST, FOREST HILLS, NY 11375-1611
(718) 902-1958
(718) 459-2222
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
237182
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02720818
—
NY
01
—
2657293
UNITEDHEALTHCARE
NY
01
—
P3708717
OXFORD
NY
Enumeration date
02/05/2007
Last updated
08/22/2020
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