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Individual

MARINA ZIMARA SAMPAGA

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
4430 MACNISH ST, ELMHURST, NY 11373
(718) 424-0782
Mailing address
9309 74TH PLACE, WOODHAVEN, NY 11421
(917) 885-5205
(718) 296-3425

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
157254
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00811174
NY
Enumeration date
05/11/2006
Last updated
07/08/2007
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