Provider Demographics
NPI:1245766708
Name:MUSINOVA, NARGIZA
Entity Type:Individual
Prefix:
First Name:NARGIZA
Middle Name:
Last Name:MUSINOVA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 BAY 29TH ST
Mailing Address - Street 2:APT 1J
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-4050
Mailing Address - Country:US
Mailing Address - Phone:347-868-6623
Mailing Address - Fax:860-900-7817
Practice Address - Street 1:30 BAY 29TH ST APT 1J
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-4015
Practice Address - Country:US
Practice Address - Phone:347-868-6623
Practice Address - Fax:860-900-7817
Is Sole Proprietor?:No
Enumeration Date:2017-05-03
Last Update Date:2017-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program