Individual
DR. CAMILLE JOSEPHINE SIROTNIKOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5645 MAIN ST, FLUSHING, NY 11355-5045
(800) 465-3203
Mailing address
101 DARTMOUTH ST, VALLEY STREAM, NY 11581-3215
(347) 549-5468
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
324614
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/18/2020
Last updated
08/24/2023
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