Individual
IANA BOKTAEVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
29 SUNNYSIDE TER APT 2, STATEN ISLAND, NY 10301-4035
(929) 406-8513
(929) 406-8513
Mailing address
29 SUNNYSIDE TER APT 2, STATEN ISLAND, NY 10301-4035
(929) 406-8513
(929) 406-8513
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
06/17/2025
Last updated
06/17/2025
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