Organization
DIPLOMAT MEDICAL GROUP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NARGIZA SOBIROVA (CREDENTIALING SPECIALIST)
(718) 934-6714
Entity
Organization
Contact information
Practice address
11515 QUEENS BLVD STE 1, FOREST HILLS, NY 11375
(718) 807-1634
Mailing address
11515 QUEENS BLVD STE 1, FOREST HILLS, NY 11375
(718) 807-1634
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Enumeration date
01/10/2023
Last updated
01/10/2023
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