Provider Demographics
NPI:1093909798
Name:GADAYEVA, VIOLETTA (NP)
Entity Type:Individual
Prefix:MRS
First Name:VIOLETTA
Middle Name:
Last Name:GADAYEVA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1014 S END
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-1027
Mailing Address - Country:US
Mailing Address - Phone:516-341-7023
Mailing Address - Fax:
Practice Address - Street 1:1014 S END
Practice Address - Street 2:
Practice Address - City:WOODMERE
Practice Address - State:NY
Practice Address - Zip Code:11598-1027
Practice Address - Country:US
Practice Address - Phone:516-341-7023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-05
Last Update Date:2016-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF304533-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health