Basic Information
| Provider Information | |||||||||
| NPI: | 1023171063 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MIHAJLOV | ||||||||
| FirstName: | IGOR | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 32 BENDING OAK DR | ||||||||
| Address2: | |||||||||
| City: | PITTSFORD | ||||||||
| State: | NY | ||||||||
| PostalCode: | 145343325 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5853819670 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1111 ELMWOOD AV | ||||||||
| Address2: | |||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 14620 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5852411200 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/19/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 110222 | NY | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.