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MAZUROV MEDICAL PC
NPI 1003104456
Specialist in Staten Island, NY

Active since July 19, 2011
505 JEFFERSON BLVD, STATEN ISLAND, NY 10312(718) 966-1738 Get Directions Write a Review

NPPES record last updated: July 19, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mazurov Medical Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MAZUROV MEDICAL PC (NPI 1003104456) is a healthcare organization registered as a specialist in Staten Island, New York and active in the NPI registry since July 2011. The organization lists Boris Mazurov, Owner, as its authorized official.

NPPES Registry Identity

NPI1003104456
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameMAZUROV MEDICAL PC
Location Address505 JEFFERSON BLVDStaten Island, NY 10312-2225
Mailing Address505 Jefferson BlvdStaten Island, NY 10312-2225
Phone(718) 966-1738
Organization SubpartNo
Authorized OfficialBoris MazurovOwner · (718) 966-1738
Enumeration DateJuly 19, 2011
✔ NPI 1003104456 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in NY · 210722-1
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
505 JEFFERSON BLVD, Staten Island, NY 10312
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mazurov Medical PC's NPI number?

The NPI number for Mazurov Medical PC is 1003104456. It was assigned to this organization in the NPPES registry on July 19, 2011.

Where is Mazurov Medical PC located?

Mazurov Medical PC is located at 505 Jefferson Blvd, Staten Island, NY 10312. The listed phone number is (718) 966-1738.

What is Mazurov Medical PC's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Mazurov Medical PC was last updated on July 19, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.