Individual ProviderMarina PodvalInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address4332 Kissena Blvd, La, Flushing, NY 11355-2934(718) 939-0609PECOS EnrollmentBased on the most recent information from CMS, provider Marina Podval is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1982717237Provider TypeIndividualFull NamePodval, MarinaCredentialMDGenderFemaleSole ProprietorYesEnumeration Date8/17/2006Last Updated5/29/2012Contact InformationPractice LocationPractice Address4332 Kissena Blvd, La, Flushing, NY 11355-2934Phone(718) 939-0609Fax(718) 939-4509Mailing LocationMailing Address4332 Kissena Blvd, La, Flushing, NY 11355-2934Phone(718) 939-0609Fax(718) 939-4509Provider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense214459New YorkProvider IdentifiersIDDescriptionIssuerID02041798DescriptionMedicaidIssuerUnlistedNew York