Provider Demographics
| NPI: | 1174232953 |
|---|---|
| Name: | RAHMANOVA, VIKTORIA (RN, CWOCN) |
| Entity type: | Individual |
| Prefix: | MRS |
| First Name: | VIKTORIA |
| Middle Name: | |
| Last Name: | RAHMANOVA |
| Suffix: | |
| Gender: | F |
| Credentials: | RN, CWOCN |
| Other - Prefix: | |
| Other - First Name: | |
| Other - Middle Name: | |
| Other - Last Name: | |
| Other - Suffix: | |
| Other - Last Name Type: | |
| Other - Credentials: | |
| Mailing Address - Street 1: | 33 JOVAL CT |
| Mailing Address - Street 2: | |
| Mailing Address - City: | BROOKLYN |
| Mailing Address - State: | NY |
| Mailing Address - Zip Code: | 11229-5966 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 718-288-4031 |
| Mailing Address - Fax: | 775-258-7029 |
| Practice Address - Street 1: | 33 JOVAL CT |
| Practice Address - Street 2: | |
| Practice Address - City: | BROOKLYN |
| Practice Address - State: | NY |
| Practice Address - Zip Code: | 11229-5966 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 718-288-4031 |
| Practice Address - Fax: | 775-258-7029 |
| Is Sole Proprietor?: | Yes |
| Enumeration Date: | 2022-11-21 |
| Last Update Date: | 2022-11-21 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| NY | 612476 | 163WC2100X, 163WX1500X, 163WW0000X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 163WW0000X | Nursing Service Providers | Registered Nurse | Wound Care |
| No | 163WC2100X | Nursing Service Providers | Registered Nurse | Continence Care |
| No | 163WX1500X | Nursing Service Providers | Registered Nurse | Ostomy Care |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| 000000 | Other | N/A |