Organization
NEW YORK INNOVATIVE MEDICAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA DOLGOVINA M.D. (PRACTITIONER)
(917) 557-0202
Entity
Organization
Contact information
Practice address
8589 67TH AVE, REGO PARK, NY 11374-5226
(917) 557-0202
Mailing address
8589 67TH AVE, REGO PARK, NY 11374-5226
(917) 557-0202
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
261794
NY
Other
Enumeration date
03/21/2012
Last updated
03/21/2012
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