| NPI | 1659758621 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALINA BOSHAKOVA Np 347-729-5904 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F306361-1) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 569215-1) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: NY F340890-1) | |
| Enumeration Date | 2015-04-29 |
| Last Update Date | 2016-02-02 |