# NP ADULT HEALTH & GERONTOLOGY PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659758621
- **Authorized official:** MS. ALINA BOSHAKOVA (NP)
- **Authorized official phone:** (347) 729-5904

## Contact information

- **Practice address:** 126 CORBIN PL, BROOKLYN, NY 11235-4811
- **Practice address phone:** (347) 729-5904
- **Mailing address:** 126 CORBIN PL, BROOKLYN, NY 11235-4811
- **Mailing address phone:** (347) 729-5904

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163W00000X | Registered Nurse | 569215-1 | NY | — |
| 363LA2200X | Adult Health Nurse Practitioner | F306361-1 | NY | Yes |
| 363LG0600X | Gerontology Nurse Practitioner | F340890-1 | NY | — |

## Other

- **Enumeration date:** 04/29/2015
- **Last updated:** 02/02/2016