Provider Demographics
NPI:1902063258
Name:MAGANOV, IGOR ANATOLYEVICH (MD)
Entity Type:Individual
Prefix:MR
First Name:IGOR
Middle Name:ANATOLYEVICH
Last Name:MAGANOV
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2072 20TH LANE
Mailing Address - Street 2:APT 3C
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-6369
Mailing Address - Country:US
Mailing Address - Phone:347-374-2142
Mailing Address - Fax:718-815-8122
Practice Address - Street 1:2072 20TH LANE
Practice Address - Street 2:APT 3C
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-6369
Practice Address - Country:US
Practice Address - Phone:347-374-2142
Practice Address - Fax:718-815-8122
Is Sole Proprietor?:No
Enumeration Date:2008-05-22
Last Update Date:2010-03-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY250722207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology