Provider Demographics
NPI:1235867060
Name:AZIZKA91 CORPORATION
Entity Type:Organization
Organization Name:AZIZKA91 CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SI ABA
Authorized Official - Prefix:
Authorized Official - First Name:AZIZA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAKHMANOVA
Authorized Official - Suffix:
Authorized Official - Credentials:MSED
Authorized Official - Phone:347-792-6865
Mailing Address - Street 1:29 MURDOCK CT APT 3J
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-6410
Mailing Address - Country:US
Mailing Address - Phone:347-791-6865
Mailing Address - Fax:
Practice Address - Street 1:29 MURDOCK CT APT 3J
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-6410
Practice Address - Country:US
Practice Address - Phone:347-791-6865
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-10
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency