Individual
DILRABO ZIYAEVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8515 139TH ST, APT 5P, JAMAICA, NY 11435-2637
(347) 413-4323
Mailing address
8515 139TH ST, APT 5P, JAMAICA, NY 11435-2637
(347) 413-4323
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17
SEIT
NY
Enumeration date
06/13/2014
Last updated
09/24/2014
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