Mazol Kholdarova, M.S.
Specialist in Queens, NY. Individual provider (NPI-1).
NPI number1588097802
StatusActive
Last updated in NPPESJul 29, 2014
Details
- NPI
- 1588097802
- Entity type
- Individual (NPI-1)
- Name
- Mazol Kholdarova
- Credential
- M.S.
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 11, 2013
- Last updated
- Jul 29, 2014
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174400000X | Specialist | 1370334 | NY | Yes |
Practice location
159 - 16 Union Turnpike Suite 308Queens, NY 11366
Phone 718-275-8322 · Fax 718-263-5444
Mailing address
9805 63rd Rd Apt 10hRego Park, NY 11374-1722
Phone 347-277-4079
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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