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NPI Code Detail

MEDICARE: ELIZABETH MASHKABOV MASTERS

MEDICARE: ELIZABETH MASHKABOV MASTERS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1184242786
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH MASHKABOV MASTERS
Provider Business Mailing Address
First Line : 6435 YELLOWSTONE BLVD APT 1J
Second Line :
City : FOREST HILLS
State : NY
Zip : 11375-1725
Country : US
Telephone Number : 917-403-9633
Fax Number :
Provider Business Practice Location Address
First Line : 11506 ROCKAWAY BEACH BLVD
Second Line :
City : FAR ROCKAWAY
State : NY
Zip : 11694-2346
Country : US
Telephone Number : 718-554-7766
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/09/2020
Last Update Date : 07/09/2020

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Directions to “ ELIZABETH MASHKABOV MASTERS” Practice Location

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