Healthcare Provider Details
I. General information
NPI: 1174643456
Provider Name (Legal Business Name): LYUDMILA OSLON PEDIATRICS P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/30/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
15028 UNION TPKE STE 500
FLUSHING NY
11367-3900
US
IV. Provider business mailing address
15028 UNION TPKE STE 500
FLUSHING NY
11367-3900
US
V. Phone/Fax
- Phone: 718-969-4357
- Fax:
- Phone: 718-969-4357
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 173000000X |
| Taxonomy | Legal Medicine |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
LYUDMILA
OSLON
Title or Position: OWNER
Credential: M.D.
Phone: 718-969-4357