Individual
FARIDA L MUKHTASIMOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
1540 MAPLE RD, BUFFALO, NY 14221-3647
(716) 568-3600
Mailing address
3825 WILDWING DR, NORTH TONAWANDA, NY 14120-1383
(716) 533-3249
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2024102417
NY
Other
Enumeration date
02/22/2025
Last updated
02/22/2025
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