Provider Demographics
NPI:1437505807
Name:STOZHKOV, INGA
Entity Type:Individual
Prefix:MRS
First Name:INGA
Middle Name:
Last Name:STOZHKOV
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3096 BRIGHTON 6TH ST
Mailing Address - Street 2:APT C10
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-6951
Mailing Address - Country:US
Mailing Address - Phone:917-937-1404
Mailing Address - Fax:
Practice Address - Street 1:3096 BRIGHTON 6TH ST
Practice Address - Street 2:APT C10
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-6951
Practice Address - Country:US
Practice Address - Phone:917-937-1404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-04
Last Update Date:2016-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies