Individual
TIMUR MUSHEKOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
600 E 233RD ST, BRONX, NY 10466-2604
(718) 920-9826
Mailing address
9211 101ST AVE APT 2F, OZONE PARK, NY 11416-2319
(917) 628-7062
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
006730-1
NY
363AM0700X
Medical Physician Assistant
006730-1
NY
Other
Enumeration date
09/04/2009
Last updated
09/21/2009
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