Provider Demographics
NPI:1568820348
Name:BELIAKOV, ALLA (RN)
Entity Type:Individual
Prefix:
First Name:ALLA
Middle Name:
Last Name:BELIAKOV
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ALLA
Other - Middle Name:
Other - Last Name:AZAROVA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:6561 SAUNDERS ST
Mailing Address - Street 2:5J
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-4252
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6561 SAUNDERS ST
Practice Address - Street 2:5J
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-4252
Practice Address - Country:US
Practice Address - Phone:718-275-6708
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-08
Last Update Date:2016-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY691703163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse