Organization
POLYXENA MEDICAL CORPORATION PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TATIANA MAMAEVA M.D. (OWNER)
(212) 410-2539
Entity
Organization
Contact information
Practice address
1556 3RD AVE, NEW YORK, NY 10128-3100
(212) 410-2539
Mailing address
1556 3RD AVE, NEW YORK, NY 10128-3100
(212) 410-2539
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
—
—
Other
Enumeration date
06/10/2008
Last updated
06/10/2008
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