Provider Demographics
NPI:1578987400
Name:STOEVA, PETRANKA
Entity Type:Individual
Prefix:
First Name:PETRANKA
Middle Name:
Last Name:STOEVA
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 1:2522 STEINWAY ST APT 2D
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11103-3713
Mailing Address - Country:US
Mailing Address - Phone:917-476-8449
Mailing Address - Fax:
Practice Address - Street 1:2522 STEINWAY ST APT 2D
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11103-3713
Practice Address - Country:US
Practice Address - Phone:917-476-8449
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-12
Last Update Date:2014-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY623769163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse