Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 076470 | NY |
NPI | 1003056052 |
---|---|
Provider Name | Anna Markova |
First Address | Brooklyn, NY 11230-6106 |
Second Address | Brooklyn, NY 11235-6302 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/03/2009 |
Last Update Date | 04/03/2009 |