Organization
21ST CENTURY MEDICAL PLAZA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IRINA BENYAMINOVA D.O. (PRESIDENT)
(917) 400-2530
Entity
Organization
Contact information
Practice address
8716 63RD DR, REGO PARK, NY 11374-4826
(917) 400-2530
Mailing address
8716 63RD DR, REGO PARK, NY 11374-4826
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
240556
NY
Other
Enumeration date
12/08/2008
Last updated
12/08/2008
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