Doctor Name: | MAZOL KHOLDAROVA |
NPI Number: | 1588097802 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S. |
License Number: | 1370334 |
Business Practice Address: | 159 - 16 Union Turnpike Suite 308 Queens, NY - 11366 |
Business Phone Number: | 7182758322 |
Business Fax Number: | 7182635444 |
Mailing Address: | 9805 63rd Rd Apt 10h, REGO PARK |
State: | NY |
Postal Code: | 113741722 |
Phone Number: | 3472774079 |
Fax Number: | |
NPI Enumeration Date: | 08/11/2013 |
NPI Last Update Date: | 07/29/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 1370334 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |