Provider Demographics
NPI:1023361235
Name:MORJANAEVA, ZOIA
Entity Type:Individual
Prefix:
First Name:ZOIA
Middle Name:
Last Name:MORJANAEVA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1877 OCEAN AVE
Mailing Address - Street 2:6M
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-6867
Mailing Address - Country:US
Mailing Address - Phone:718-887-1574
Mailing Address - Fax:
Practice Address - Street 1:1877 OCEAN AVE
Practice Address - Street 2:6M
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-6867
Practice Address - Country:US
Practice Address - Phone:718-887-1574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-25
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY663964163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse