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Individual

DR. ALLA SHAKHANOVA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
4241 HYLAN BLVD, STATEN ISLAND, NY 10312
(718) 967-7016
(718) 605-4426
Mailing address
4241 HYLAN BLVD, STATEN ISLAND, NY 10312
(718) 967-7016
(718) 605-4426

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
205672
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01842346
NY
Enumeration date
04/19/2006
Last updated
05/01/2008
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