Individual
OLGA MASTUROVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
16416 76TH RD, FRESH MEADOWS, NY 11366-1255
(917) 622-7940
Mailing address
16416 76TH RD, FRESH MEADOWS, NY 11366-1255
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
616459-1
NY
Other
Enumeration date
03/20/2015
Last updated
03/20/2015
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