| Marina Podval Pc | |
|
4332 Kissena Blvd Suite La Flushing NY 11355-2934 | |
| (718) 939-0609 | |
| (718) 939-4509 |
| Full Name | Marina Podval Pc |
|---|---|
| Speciality | Urology |
| Location | 4332 Kissena Blvd, Flushing, New York |
| Authorized Official Name and Position | Marina Podval (OWNER) |
| Authorized Official Contact | 7189390609 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Marina Podval Pc 43-32 Kissena Blvd. La Flushing NY 11355 Ph: (718) 939-0609 | Marina Podval Pc 4332 Kissena Blvd Suite La Flushing NY 11355-2934 Ph: (718) 939-0609 |
| NPI Number | 1508904764 |
|---|---|
| Provider Enumeration Date | 02/01/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508904764 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 214459 (New York) | Primary |
| 207V00000X | Obstetrics & Gynecology | 241828 (New York) | Primary |
| 208800000X | Urology | 236385-1 (New York) | Primary |
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