Provider Demographics
NPI:1346560232
Name:KUVALDINA, ANJELIKA G (RN)
Entity Type:Individual
Prefix:DR
First Name:ANJELIKA
Middle Name:G
Last Name:KUVALDINA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 BAY 29TH ST
Mailing Address - Street 2:APT.4A
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-4013
Mailing Address - Country:US
Mailing Address - Phone:347-768-0760
Mailing Address - Fax:
Practice Address - Street 1:15 BAY 29TH ST
Practice Address - Street 2:APT.4A
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-4013
Practice Address - Country:US
Practice Address - Phone:347-768-0760
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-02
Last Update Date:2010-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY626820-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYSF07879QMedicaid