Provider Demographics
NPI:1013258003
Name:DIKAREVA, NADEZDA (RN)
Entity type:Individual
Prefix:MRS
First Name:NADEZDA
Middle Name:
Last Name:DIKAREVA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2041 85TH ST APT 2F
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-3248
Mailing Address - Country:US
Mailing Address - Phone:347-276-3346
Mailing Address - Fax:
Practice Address - Street 1:2041 85TH ST APT 2F
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-3248
Practice Address - Country:US
Practice Address - Phone:347-276-3346
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-15
Last Update Date:2013-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY664001163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse