MNB Medical PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

237182 Issued in NY

Legal business name

MNB MEDICAL PC

Practice address

6442 108TH St
Forest Hills, NY 11375-1611

Phone

(718) 902-1958

Fax

(718) 459-2222

NPI assigned

Feb 5, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mazoltuv Borukhova, M.D.NPI 1790730422

Title

Director

Phone

(718) 902-1958

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mazoltuv Borukhova, MD

  • Internal Medicine Physician
  • Forest Hills, NY
  • NPI 1790730422
  NPD (past) Authorized official
• Arthur Natanov, D.D.S.

  • General Practice Dentistry
  • Forest Hills, NY
  • NPI 1962677914
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1407995855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6442 108TH ST",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113751611",
            "telephone_number": "718-902-1958",
            "fax_number": "718-459-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6442 108TH ST",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113751611",
            "telephone_number": "718-902-1958",
            "fax_number": "718-459-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MNB MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BORUKHOVA",
        "authorized_official_first_name": "MAZOLTUV",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "718-902-1958",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "237182",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P3708717",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02720818",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITEDHEALTHCARE",
            "identifier": "2657293",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• MK Vision Center I, Inc
• MK Vision Center LLC
• MLG Medical , P.C.
• Monika Ewa Mlynarczyk, PT
• MM Medical Service PC
• Mobilecare Physical Therapy, PC
• Modern Dental of Queens P.C.
• Dylicia Modeste- George
• Lisa Maria Modesto, O.D.
• Behnam Y Moghadasian, D.D.S

• Specialist in Forest Hills, NY
• Providers in Forest Hills, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.