Individual
ALBERT MAVASHEV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPA-C
Contact information
Practice address
420 LEXINGTON AVE # 1041, NEW YORK, NY 10170-0002
(212) 999-5999
Mailing address
5909 18TH AVE, BROOKLYN, NY 11204-2202
(212) 999-5999
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
026048
NY
Other
Enumeration date
12/23/2020
Last updated
06/17/2021
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