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General NPI Number Information
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NPI Number | 1972556603
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Entity Type | Organization
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Legal Business Name | MAYA'S MEDICAL P.C.
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Dates
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Enumeration Date | 05/17/2006
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Last Update Date | 12/07/2007
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Provider Practice Location Address
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Address Line | 9811 QUEENS BLVD LL3
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City | REGO PARK
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State | NY
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Zip | 11374-3323
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Country | US
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Telephone | 718-743-7090
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Fax |
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Provider Business Mailing Address
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Address Line | 62 98 SAUNDERS ST. #5L
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City | REGO PARK
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State | NY
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Zip | 11374
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Country | US
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Telephone | 718-743-7090
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MAYA MUNAROVA
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Credential |
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Telephone | 718-730-0953
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 231069
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License Number State | NY
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