Provider Demographics
NPI:1649741869
Name:ND MEDICAL PC
Entity Type:Organization
Organization Name:ND MEDICAL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NADIRE
Authorized Official - Middle Name:
Authorized Official - Last Name:DZHALTUROVA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:646-288-9144
Mailing Address - Street 1:2402 63RD ST APT E3
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-3441
Mailing Address - Country:US
Mailing Address - Phone:646-288-9144
Mailing Address - Fax:718-645-1148
Practice Address - Street 1:4119 18TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-5709
Practice Address - Country:US
Practice Address - Phone:718-245-6042
Practice Address - Fax:718-880-9219
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-16
Last Update Date:2018-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty