Active NPI
Mazol Kholdarova, M.S.
- Specialist
- Queens, NY
National Provider Identifier
1588097802
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 1370334
- Practice address
- 159 - 16 Union Turnpike Suite 308
Queens, NY 11366 - Phone
- (718) 275-8322
- Fax
- (718) 263-5444
- NPI assigned
- Aug 11, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 1370334 | NY | Primary |
Addresses
Primary practice location
159 - 16 Union Turnpike Suite 308
Queens, NY 11366
Mailing address
9805 63Rd Rd Apt 10H
Rego Park, NY 11374-1722
Phone (347) 277-4079
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1370334 | NY | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1376179200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1406592000000",
"number": "1588097802",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9805 63RD RD APT 10H",
"city": "REGO PARK",
"state": "NY",
"postal_code": "113741722",
"telephone_number": "347-277-4079"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "159 - 16 UNION TURNPIKE SUITE 308",
"city": "QUEENS",
"state": "NY",
"postal_code": "11366",
"telephone_number": "718-275-8322",
"fax_number": "718-263-5444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHOLDAROVA",
"first_name": "MAZOL",
"credential": "M.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-08-11",
"last_updated": "2014-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NY",
"license": "1370334",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Queens, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.