Individual
ETEL SHARIPOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
450 CLARKSON AVE, BROOKLYN, NY 11203-2012
(718) 270-7707
Mailing address
450 CLARKSON AVE, BROOKLYN, NY 11203-2012
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
029440
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/14/2022
Last updated
12/19/2023
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