Individual
ASAL GUDIMOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NEMT
Contact information
Practice address
2705 CONEY ISLAND AVE, BROOKLYN, NY 11235-5004
(929) 888-9092
Mailing address
2705 CONEY ISLAND AVE, BROOKLYN, NY 11235-5004
Taxonomy
Speciality
Code
Description
License number
State
405300000X
Prevention Professional
Primary
3393823
NY
Other
Enumeration date
02/10/2020
Last updated
02/10/2020
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