Provider Demographics
NPI:1235445099
Name:MULLAYEVA, EMILIYA (FNP)
Entity Type:Individual
Prefix:
First Name:EMILIYA
Middle Name:
Last Name:MULLAYEVA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 ERIKA LOOP
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312-6659
Mailing Address - Country:US
Mailing Address - Phone:917-365-7967
Mailing Address - Fax:
Practice Address - Street 1:11882 METROPOLITAN AVE
Practice Address - Street 2:
Practice Address - City:KEW GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11415-2001
Practice Address - Country:US
Practice Address - Phone:516-300-0304
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-31
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY507302-1163WA0400X
NYF337847-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)