Dabakarov Family Health Nurse Practitioner Pc | |
7315 194th St Fresh Meadows NY 11366-1835 | |
(347) 684-6605 | |
Not Available |
Full Name | Dabakarov Family Health Nurse Practitioner Pc |
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Speciality | Clinic/Center |
Location | 7315 194th St, Fresh Meadows, New York |
Authorized Official Name and Position | Vyacheslav Dabakarov (OWNER) |
Authorized Official Contact | 3476846605 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Dabakarov Family Health Nurse Practitioner Pc 7315 194th St Fresh Meadows NY 11366-1835 Ph: (347) 684-6605 | Dabakarov Family Health Nurse Practitioner Pc 7315 194th St Fresh Meadows NY 11366-1835 Ph: (347) 684-6605 |
NPI Number | 1467142133 |
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Provider Enumeration Date | 05/08/2023 |
Last Update Date | 05/08/2023 |
Medicare PECOS PAC ID | 7810355062 |
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Medicare Enrollment ID | O20230620001988 |
Identifier | Type | State | Issuer |
---|---|---|---|
1467142133 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Provider Name | Vyacheslav Dabakarov |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1306477955 PECOS PAC ID: 8729446976 Enrollment ID: I20230620002167 |
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