Provider Demographics
NPI:1508430349
Name:RABIYEVA, YELENA
Entity Type:Individual
Prefix:
First Name:YELENA
Middle Name:
Last Name:RABIYEVA
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 1:6120 GRAND CENTRAL PKWY APT A304
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-1272
Mailing Address - Country:US
Mailing Address - Phone:347-665-7528
Mailing Address - Fax:
Practice Address - Street 1:14227 FRANKLIN AVE
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-2629
Practice Address - Country:US
Practice Address - Phone:718-670-3400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-17
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY506510163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice