Provider Demographics
NPI:1700387719
Name:PINKHASOVA, MILENA
Entity Type:Individual
Prefix:
First Name:MILENA
Middle Name:
Last Name:PINKHASOVA
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 1:7925 150TH ST APT A27
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-3804
Mailing Address - Country:US
Mailing Address - Phone:718-909-9740
Mailing Address - Fax:
Practice Address - Street 1:7925 150TH ST APT A27
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-3804
Practice Address - Country:US
Practice Address - Phone:718-909-9740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-25
Last Update Date:2020-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1390664201174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist