Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 223268-1 | NY |
NPI | 1013089986 |
---|---|
Provider Name | Alexey Migirov |
First Address | Staten Island, NY 10308-1877 |
Second Address | Brooklyn, NY 11235-6308 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2006 |
Last Update Date | 13/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02461943 | (05) | NY |
I02793 | (02) |