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 provides Specialist services 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 Not confirmed with CMS for 15 years — call before visiting
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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