Individual
LEYSAN MINGALIEVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2334 E 28TH ST, BROOKLYN, NY 11229-5034
(347) 922-4349
Mailing address
2334 E 28TH ST, BROOKLYN, NY 11229-5034
(347) 922-4349
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1144832809
—
NY
Enumeration date
01/17/2023
Last updated
01/17/2023
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