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NPI Code Detail

MEDICARE: LYUBOV MASHKABOVA DDS

MEDICARE: LYUBOV MASHKABOVA DDS
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
11223D0001XPublic Health Dentistry0497001NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1528066339
Entity Type Code : Individual
Provider Name (Legal Business Name) : LYUBOV MASHKABOVA DDS
Provider Business Mailing Address
First Line : 16611 81ST AVE
Second Line :
City : JAMAICA
State : NY
Zip : 11432-1203
Country : US
Telephone Number : 718-945-7150
Fax Number : 718-945-2596
Provider Business Practice Location Address
First Line : 6200 BEACH CHANNEL DR
Second Line :
City : ARVERNE
State : NY
Zip : 11692-1409
Country : US
Telephone Number : 718-945-7150
Fax Number : 718-945-2596
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2005
Last Update Date : 02/14/2013

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Directions to “ LYUBOV MASHKABOVA DDS” Practice Location

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