| Dr.izolda Mikhaylov | |
|
9815 Horace Harding Expy Corona NY 11368-4249 | |
| (718) 699-8500 | |
| Not Available |
| Full Name | Dr.izolda Mikhaylov |
|---|---|
| Speciality | Family Medicine |
| Location | 9815 Horace Harding Expy, Corona, New York |
| Authorized Official Name and Position | Izolda Mikhaylov (MEDICAL DIRECTOR) |
| Authorized Official Contact | 7184690890 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr.izolda Mikhaylov 785 Van Dam St Valley Stream NY 11581-3523 Ph: (718) 469-0890 | Dr.izolda Mikhaylov 9815 Horace Harding Expy Corona NY 11368-4249 Ph: (718) 699-8500 |
| NPI Number | 1477574119 |
|---|---|
| Provider Enumeration Date | 07/21/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477574119 | NPI | - | NPPES |
| 02313197 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 223885 (New York) | Primary |
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