Individual
MRS. EMMA BAGDASAROV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
456 WAVERLY AVE, PATCHOGUE, NY 11772-1586
(631) 447-6460
Mailing address
226 CLEVELAND AVE APT 2, MINEOLA, NY 11501-2578
(516) 592-8323
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
633774-1
NY
Other
Enumeration date
10/03/2012
Last updated
10/03/2012
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