Individual
LARISA MAKAROV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
150 55TH ST, BROOKLYN, NY 11220-2508
(347) 792-8304
Mailing address
2955 SHELL RD APT 5J, BROOKLYN, NY 11224-3645
(347) 792-8304
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
019910
NY
Other
Enumeration date
08/18/2016
Last updated
08/18/2016
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