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General NPI Number Information
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NPI Number | 1912491556
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Entity Type | Organization
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Legal Business Name | GRIGORIY MASHKEVICH MD PC
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Dates
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Enumeration Date | 06/18/2018
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Last Update Date | 06/18/2018
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Provider Practice Location Address
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Address Line | 925 PARK AVE
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City | NEW YORK
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State | NY
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Zip | 10028-0210
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Country | US
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Telephone | 212-737-8700
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2625
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City | NEW YORK
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State | NY
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Zip | 10009-8925
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | BILLING
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Name | EMILY LAM
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Credential |
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Telephone | 914-222-0828
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207YX0905X
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Taxonomy Name | Otolaryngology/Facial Plastic Surgery Physician
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License Number |
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License Number State |
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