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Individual

MRS. INESSA NATANOV

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
9785 QUEENS BLVD, REGO PARK, NY 11374-3319
(718) 261-9100
(718) 897-2915
Mailing address
9777 QUEENS BLVD, REGO PARK, NY 11374-3335
(718) 261-9100
(718) 897-2915

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
011968
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
011968
LICENSE
NY
Enumeration date
02/14/2008
Last updated
02/01/2012
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