Organization
MO-MA MEDICAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRIGORIY MASHKEVICH (AUTHORIZED OFFICIAL)
(212) 737-8700
Entity
Organization
Contact information
Practice address
925 PARK AVE, NEW YORK, NY 10028-0210
(212) 737-8700
Mailing address
925 PARK AVE, NEW YORK, NY 10028-0210
(212) 737-8700
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
—
—
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Enumeration date
02/13/2023
Last updated
03/28/2023
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