Provider Demographics
NPI:1841593076
Name:VOROBYOVA, MARGARITA
Entity Type:Individual
Prefix:
First Name:MARGARITA
Middle Name:
Last Name:VOROBYOVA
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 1:8835 23RD AVE APT F8
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-5727
Mailing Address - Country:US
Mailing Address - Phone:646-236-1669
Mailing Address - Fax:
Practice Address - Street 1:8835 23RD AVE
Practice Address - Street 2:APT # F8
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-5748
Practice Address - Country:US
Practice Address - Phone:646-236-1669
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-09
Last Update Date:2010-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY300906-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY741758684-00OtherFIDELIS CARE