Provider Demographics
NPI:1477308021
Name:KARIMOV, MASRUR (PSYCHOTHERAPIST)
Entity Type:Individual
Prefix:
First Name:MASRUR
Middle Name:
Last Name:KARIMOV
Suffix:
Gender:M
Credentials:PSYCHOTHERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6901 21ST AVE APT 4E
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-5426
Mailing Address - Country:US
Mailing Address - Phone:347-543-5518
Mailing Address - Fax:
Practice Address - Street 1:6901 21ST AVE APT 4E
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-5426
Practice Address - Country:US
Practice Address - Phone:347-543-5518
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-18
Last Update Date:2024-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent