Provider Demographics
NPI:1215577010
Name:MURDAKHAEV, MILANA (NP)
Entity Type:Individual
Prefix:
First Name:MILANA
Middle Name:
Last Name:MURDAKHAEV
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 1:2001 MARCUS AVE STE W290
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042-1098
Mailing Address - Country:US
Mailing Address - Phone:516-465-5255
Mailing Address - Fax:516-326-4510
Practice Address - Street 1:2001 MARCUS AVE STE W290
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-1098
Practice Address - Country:US
Practice Address - Phone:516-465-5255
Practice Address - Fax:718-347-2240
Is Sole Proprietor?:No
Enumeration Date:2020-01-09
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY663321163W00000X
NY383463363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163W00000XNursing Service ProvidersRegistered Nurse