Provider Demographics
NPI:1407167588
Name:KUMURDJIEVA, VIOLETA I (MA)
Entity Type:Individual
Prefix:MRS
First Name:VIOLETA
Middle Name:I
Last Name:KUMURDJIEVA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6441 SAUNDERS ST
Mailing Address - Street 2:APT. 207
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-3248
Mailing Address - Country:US
Mailing Address - Phone:718-786-3383
Mailing Address - Fax:
Practice Address - Street 1:6441 SAUNDERS ST
Practice Address - Street 2:APT. 207
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-3248
Practice Address - Country:US
Practice Address - Phone:718-786-3383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-23
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist