# GRIGORIY MASHKEVICH MD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912491556
- **Authorized official:** EMILY LAM (BILLING)
- **Authorized official phone:** (914) 222-0828

## Contact information

- **Practice address:** 925 PARK AVE, NEW YORK, NY 10028-0210
- **Practice address phone:** (212) 737-8700
- **Mailing address:** PO BOX 2625, NEW YORK, NY 10009-8925

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207YX0905X | Otolaryngology/Facial Plastic Surgery Physician | — | NULL | Yes |
| 207YX0905X | Otolaryngology/Facial Plastic Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/18/2018
- **Last updated:** 06/18/2018