Provider Demographics
NPI:1568239168
Name:NAZAROVA, EKATERINA (MS)
Entity Type:Individual
Prefix:
First Name:EKATERINA
Middle Name:
Last Name:NAZAROVA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2391 BEDFORD AVE APT S5C
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-5471
Mailing Address - Country:US
Mailing Address - Phone:443-986-0413
Mailing Address - Fax:
Practice Address - Street 1:330 CROWN ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11225-3004
Practice Address - Country:US
Practice Address - Phone:646-790-2129
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-05
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist