Individual
IRINA KIMYAGAROVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
9424 63RD DR, REGO PARK, NY 11374-2028
(917) 977-1107
Mailing address
9424 63RD DR, REGO PARK, NY 11374-2028
(917) 977-1107
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
222382-1
NY
Other
Enumeration date
04/14/2009
Last updated
04/14/2009
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