Individual
RENA AGAYEVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1651 CONEY ISLAND AVE, BROOKLYN, NY 11230-5849
(718) 998-1415
Mailing address
PO BOX 230346, BROOKLYN, NY 11223-0346
(917) 374-0853
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
709046
NY
Other
Enumeration date
10/22/2013
Last updated
10/22/2013
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