Provider Demographics
NPI:1467892539
Name:MIKHAYLOVA, MARGARITA (DO)
Entity Type:Individual
Prefix:
First Name:MARGARITA
Middle Name:
Last Name:MIKHAYLOVA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:RITA
Other - Middle Name:
Other - Last Name:MIKHAYLOVA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:10821 67TH AVE
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-2336
Mailing Address - Country:US
Mailing Address - Phone:646-932-6899
Mailing Address - Fax:
Practice Address - Street 1:1035 PARK AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028-0912
Practice Address - Country:US
Practice Address - Phone:212-987-0100
Practice Address - Fax:212-987-1754
Is Sole Proprietor?:No
Enumeration Date:2013-07-03
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2860752084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology