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General NPI Number Information
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NPI Number | 1992959878
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Entity Type | Organization
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Legal Business Name | NODAR KOZHIN MD P.C.
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Dates
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Enumeration Date | 11/05/2008
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Last Update Date | 11/05/2008
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Provider Practice Location Address
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Address Line | 6960 108TH ST 101
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City | FOREST HILLS
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State | NY
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Zip | 11375-4323
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Country | US
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Telephone | 718-275-8200
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Fax | 718-896-3166
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Provider Business Mailing Address
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Address Line | 6960 108TH ST 101
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City | FOREST HILLS
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State | NY
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Zip | 11375-4323
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Country | US
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Telephone | 718-275-8200
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Fax | 718-896-3166
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Authorized Official
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Title or Position | OWNER
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Name | DR. NODAR KOZHIN
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Credential | MD
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Telephone | 718-275-8200
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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 | 139141
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License Number State | NY
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