Individual
MARIYA SIYANOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10719 70TH AVE APT 110, FOREST HILLS, NY 11375-4315
(917) 476-8112
Mailing address
10719 70TH AVE APT 110, FOREST HILLS, NY 11375-4315
(917) 476-8112
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
309608
NY
Other
Enumeration date
05/18/2020
Last updated
05/18/2020
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