Individual
GOLCHEKHRA MORDEHACHAYEV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
630 FLUSHING AVE FL 2, BROOKLYN, NY 11206-5026
(718) 828-2666
Mailing address
9920 63RD AVE FL 2, REGO PARK, NY 11374-1943
(646) 932-9105
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
742004
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
742004
LICENSE NUMBER
NY
Enumeration date
01/16/2018
Last updated
01/16/2018
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