Individual
SNEZHANA MULLOKANDOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
380 NASSAU RD, LONG ISLAND FQHC, INC., ROOSEVELT, NY 11575-1343
(516) 571-8600
Mailing address
380 NASSAU RD, LONG ISLAND FQHC, INC, ROOSEVELT, NY 11575-1343
(516) 571-8600
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
242796
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02864919
—
NY
01
—
242796
NYS LICENSE
NY
Enumeration date
03/09/2007
Last updated
04/04/2014
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