Provider Demographics
NPI:1114357357
Name:ZLOBOVSKAYA, LYUBOV (REGISTERD NURSE)
Entity Type:Individual
Prefix:
First Name:LYUBOV
Middle Name:
Last Name:ZLOBOVSKAYA
Suffix:
Gender:F
Credentials:REGISTERD NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1770 E 14TH ST APT 5M
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-2062
Mailing Address - Country:US
Mailing Address - Phone:347-462-6860
Mailing Address - Fax:
Practice Address - Street 1:1770 E 14 ST APT 5M
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229
Practice Address - Country:US
Practice Address - Phone:347-462-6860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-26
Last Update Date:2013-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY628625163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse