Provider Demographics
NPI:1477332567
Name:MISHKINA TERRANE NP IN ADULT HEALTH P.C
Entity type:Organization
Organization Name:MISHKINA TERRANE NP IN ADULT HEALTH P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MISHKINA
Authorized Official - Middle Name:
Authorized Official - Last Name:TERRANE
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:646-912-1353
Mailing Address - Street 1:6241 WOODHAVEN BLVD # 2
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-3731
Mailing Address - Country:US
Mailing Address - Phone:646-912-1353
Mailing Address - Fax:
Practice Address - Street 1:6241 WOODHAVEN BLVD # 2
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-3731
Practice Address - Country:US
Practice Address - Phone:929-607-3271
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-27
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary CareGroup - Single Specialty