Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 431551 | NY |
NPI | 1003450487 |
---|---|
Provider Name | Arkadiy Abraham Murdakhayev |
First Address | Forest Hills, NY 11375-2021 |
Second Address | Forest Hills, NY 11375-2021 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/10/2019 |
Last Update Date | 29/10/2019 |