| Lola Iskhakova Physician Pllc | |
|
9916 97th St Ozone Park NY 11416-2509 | |
| (347) 420-3353 | |
| (718) 236-1055 |
| Full Name | Lola Iskhakova Physician Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 9916 97th St, Ozone Park, New York |
| Authorized Official Name and Position | Lola Iskhakova (MD) |
| Authorized Official Contact | 3474203353 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lola Iskhakova Physician Pllc 6520 Booth St # 3b Rego Park NY 11374-4084 Ph: (347) 420-3353 | Lola Iskhakova Physician Pllc 9916 97th St Ozone Park NY 11416-2509 Ph: (347) 420-3353 |
| NPI Number | 1700232857 |
|---|---|
| Provider Enumeration Date | 05/08/2016 |
| Last Update Date | 05/08/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700232857 | NPI | - | NPPES |
| 273766 | Other | MEDICAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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