Individual
DARIA GADZAEVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
407 TRAVIS AVE, STATEN ISLAND, NY 10314-6150
(347) 840-4587
Mailing address
407 TRAVIS AVE, STATEN ISLAND, NY 10314-6150
(347) 840-4587
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
P118459
NY
Other
Enumeration date
10/18/2022
Last updated
10/18/2022
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