Individual
DJURABEK ISMATOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1122 CONEY ISLAND AVE STE A, BROOKLYN, NY 11230-2345
(833) 743-0100
(718) 744-9774
Mailing address
1940 OCEAN AVE APT 6J, BROOKLYN, NY 11230-6729
(984) 377-3777
(718) 744-9774
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
LA1457148
NY
174H00000X
Health Educator
Primary
LA1457148
NY
Other
Enumeration date
10/20/2020
Last updated
10/20/2020
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