Provider Demographics
NPI:1497148134
Name:JURAEVA, NILUFAR
Entity Type:Individual
Prefix:
First Name:NILUFAR
Middle Name:
Last Name:JURAEVA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1846 COLLEGE POINT BLVD
Mailing Address - Street 2:2ND FL
Mailing Address - City:COLLEGE POINT
Mailing Address - State:NY
Mailing Address - Zip Code:11356-2261
Mailing Address - Country:US
Mailing Address - Phone:516-205-3638
Mailing Address - Fax:
Practice Address - Street 1:1846 COLLEGE POINT BLVD
Practice Address - Street 2:2ND FL
Practice Address - City:COLLEGE POINT
Practice Address - State:NY
Practice Address - Zip Code:11356-2261
Practice Address - Country:US
Practice Address - Phone:516-205-3638
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-05
Last Update Date:2015-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY693508163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse