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Individual

INNA POSTOLOV

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
630 W 168TH ST # MC28, NEW YORK, NY 10032-3725
(212) 305-1948
(212) 305-5777
Mailing address
2800 MARCUS AVE, NEW HYDE PARK, NY 11042-1113
(516) 622-6196
(516) 608-2889

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
222804-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
02186203
MEDICAID GROUP #
NY
05
02682231
NY
01
W35021
MEDICARE GROUP #
NY
Enumeration date
07/01/2006
Last updated
09/30/2015
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