Individual
ANGELLA I MASHKABOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1985 MARCUS AVE # 100, NEW HYDE PARK, NY 11042-2008
(855) 201-4988
Mailing address
6334 BOOTH ST, REGO PARK, NY 11374-2032
(917) 340-7846
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
019925-1
NY
363A00000X
Physician Assistant
Primary
019925
NY
Other
Enumeration date
07/26/2017
Last updated
09/29/2022
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