Provider Demographics
NPI:1336454743
Name:RN FAMILY PRACTICE PC
Entity Type:Organization
Organization Name:RN FAMILY PRACTICE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOSHAKOVA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:347-729-5904
Mailing Address - Street 1:126 CORBIN PL
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-4811
Mailing Address - Country:US
Mailing Address - Phone:347-729-5904
Mailing Address - Fax:
Practice Address - Street 1:126 CORBIN PL
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-4811
Practice Address - Country:US
Practice Address - Phone:347-729-5904
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-10
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care