Provider Demographics
NPI:1356649321
Name:ISKHAKOVA, SVETLANA (NP)
Entity Type:Individual
Prefix:MRS
First Name:SVETLANA
Middle Name:
Last Name:ISKHAKOVA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6360 98TH ST
Mailing Address - Street 2:APT #E2
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-2238
Mailing Address - Country:US
Mailing Address - Phone:917-330-8656
Mailing Address - Fax:718-275-0705
Practice Address - Street 1:2195 E 22ND ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-3602
Practice Address - Country:US
Practice Address - Phone:718-648-4545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-01
Last Update Date:2011-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF305476-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health