Individual
MRS. KRISTINA GURGOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
281 1ST AVE, NEW YORK, NY 10003-2925
(212) 420-4200
Mailing address
11016 62ND DR, FOREST HILLS, NY 11375-1229
(718) 795-8196
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
012493-1
NY
Other
Enumeration date
06/13/2007
Last updated
06/09/2022
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