Organization
MARINA PODVAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARINA PODVAL MD (OWNER)
(718) 939-0609
Entity
Organization
Contact information
Practice address
4332 KISSENA BLVD, SUITE LA, FLUSHING, NY 11355-2934
(718) 939-0609
(718) 939-4509
Mailing address
43-32 KISSENA BLVD. LA, FLUSHING, NY 11355
(718) 939-0609
(718) 939-4509
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
214459
NY
207V00000X
Obstetrics & Gynecology Physician
241828
NY
208800000X
Urology Physician
Primary
236385-1
NY
Other
Enumeration date
02/01/2007
Last updated
09/11/2025
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