Provider Demographics
NPI:1417333600
Name:ABDURAHMANOV, NURIT (PHARMD)
Entity Type:Individual
Prefix:
First Name:NURIT
Middle Name:
Last Name:ABDURAHMANOV
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10421 68TH DR APT A21
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-3440
Mailing Address - Country:US
Mailing Address - Phone:917-946-6282
Mailing Address - Fax:
Practice Address - Street 1:3590 E TREMONT AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10465-2005
Practice Address - Country:US
Practice Address - Phone:718-792-9258
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-11
Last Update Date:2017-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY060846183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist