New York Innovative Medical PLLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

261794 Issued in NY

Legal business name

NEW YORK INNOVATIVE MEDICAL PLLC

Practice address

8589 67TH Ave
Rego Park, NY 11374-5226

Phone

(917) 557-0202

NPI assigned

Mar 21, 2012

Organization subpart

No

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

Authorized official

Name

Maria Dolgovina, M.D.

Title

Practitioner

Phone

(917) 557-0202

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1332288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332288000000",
    "number": "1447525662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8589 67TH AVE",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113745226",
            "telephone_number": "917-557-0202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8589 67TH AVE",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113745226",
            "telephone_number": "917-557-0202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW YORK INNOVATIVE MEDICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-21",
        "last_updated": "2012-03-21",
        "status": "A",
        "authorized_official_last_name": "DOLGOVINA",
        "authorized_official_first_name": "MARIA",
        "authorized_official_title_or_position": "PRACTITIONER",
        "authorized_official_telephone_number": "917-557-0202",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NY",
            "license": "261794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Rego Park, NY
• Providers in Rego Park, NY by specialty
• Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2012; 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.