Individual
GRIGORIY MASHKEVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10812 72ND AVE STE 3, FOREST HILLS, NY 11375-7080
(718) 544-9300
(718) 544-9301
Mailing address
PO BOX 2625, NEW YORK, NY 10009-8925
(718) 544-9300
(718) 544-9301
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
A98950
CA
207YS0123X
Facial Plastic Surgery Physician
Primary
236999
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A989500
MEDI-CAL PPIN#
CA
Enumeration date
01/05/2007
Last updated
09/12/2016
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