Provider Demographics
NPI:1730119777
Name:MAKSUMOVA, ZOYA (MD)
Entity Type:Individual
Prefix:
First Name:ZOYA
Middle Name:
Last Name:MAKSUMOVA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11210 QUEENS BLVD
Mailing Address - Street 2:26E
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-6344
Mailing Address - Country:US
Mailing Address - Phone:917-692-7309
Mailing Address - Fax:
Practice Address - Street 1:200 PARK AVE S
Practice Address - Street 2:SUITE 1103
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-1503
Practice Address - Country:US
Practice Address - Phone:212-674-0444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-04
Last Update Date:2008-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2007402085R0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0205XAllopathic & Osteopathic PhysiciansRadiologyRadiological Physics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG26237Medicare UPIN