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Organization

21ST CENTURY MEDICAL PLAZA PC

Active
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Organization

21ST CENTURY MEDICAL PLAZA PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
IRINA BENYAMINOVA D.O. (PRESIDENT)
(917) 400-2530
Entity
Organization

Contact information

Practice address
8716 63RD DR, REGO PARK, NY 11374-4826
(917) 400-2530
Mailing address
8716 63RD DR, REGO PARK, NY 11374-4826

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
240556
NY

Other

Enumeration date
12/08/2008
Last updated
12/08/2008
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