Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mazurov Medical PC

Organization Specialist · NPI 1003104456

Mazurov Medical PC is a Specialist in Staten Island, New York. Licensed in New York. Registered with an NPI since 2011.

Licensed in
NY
In the registry since
2011
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

505 Jefferson Blvd
Staten Island, NY 10312-2225
Phone: (718) 966-1738
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence 210722-1 (NY)

Record details

NPI number1003104456
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Boris Mazurov — Owner · (718) 966-1738
NPI enumeratedJuly 19, 2011
Last updated in NPPESJuly 19, 2011
Mailing address505 Jefferson Blvd, Staten Island, NY 10312-2225

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