Individual
SERGEY PROKHOROV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9817 QUEENS BOULEVARD, LL2, REGO PARK, NY 11374-3336
(718) 275-5600
(718) 275-5608
Mailing address
9817 QUEENS BOULEVARD, LL2, REGO PARK, NY 11374-3336
(718) 275-5600
(718) 275-5608
Taxonomy
Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
231008
NY
Other
Enumeration date
03/02/2006
Last updated
06/10/2011
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