Provider Demographics
NPI:1285855817
Name:AKHMETOVA, DANA (DC)
Entity Type:Individual
Prefix:MS
First Name:DANA
Middle Name:
Last Name:AKHMETOVA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3900 BAILEY AVE
Mailing Address - Street 2:# 4C
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-2736
Mailing Address - Country:US
Mailing Address - Phone:917-459-5157
Mailing Address - Fax:347-275-5719
Practice Address - Street 1:3900 BAILEY AVE
Practice Address - Street 2:# 4C
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10463-2736
Practice Address - Country:US
Practice Address - Phone:917-459-5157
Practice Address - Fax:347-275-5719
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2008-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX010740111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor