Individual
IZOLDA MIKHAYLOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
6254 97TH PL STE 2B, REGO PARK, NY 11374-1354
(718) 595-1166
Mailing address
6254 97TH PL STE 2B, REGO PARK, NY 11374-1354
(718) 595-1166
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
223885
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02313197
—
NY
Enumeration date
07/19/2006
Last updated
11/08/2024
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