Individual
ANTONELLA NIYAZOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
10236 64TH AVE, FOREST HILLS, NY 11375-1547
(917) 943-3785
Mailing address
10236 64TH AVE, FOREST HILLS, NY 11375-1547
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
992756
NY
Other
Enumeration date
06/24/2025
Last updated
08/23/2025
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