Individual
DR. MARIYA A ODNOPOZOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
157-02 CROSSBAY BLVD., MEDISYS FAMILY CARE CENTER-HOWARD BEACH, HOWARD BEACH, NY 11414
(718) 323-3591
Mailing address
80 MARCUS DR, PROVIDER ENROLLMENT, MELVILLE, NY 11747-4230
(631) 391-7887
(631) 454-4163
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
221688
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02196216
—
NY
Enumeration date
08/23/2006
Last updated
03/04/2014
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