Individual
MR. ALEKSANDR KAZAKOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
9840 64TH AVE APT 1H, REGO PARK, NY 11374-2514
(718) 791-3397
Mailing address
9840 64TH AVE APT 1H, REGO PARK, NY 11374-2514
(718) 791-3397
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
020216
NY
Other
Enumeration date
10/14/2016
Last updated
10/14/2016
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