Individual
EDUARD KANDOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
8900 VAN WYCK EXPY, JAMAICA, NY 11418-2832
(718) 206-7099
Mailing address
7503 172ND ST, FRESH MEADOWS, NY 11366-1422
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
405175
NY
Other
Enumeration date
07/11/2023
Last updated
07/11/2023
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