Provider Demographics
NPI:1457883183
Name:OMARGALIYEVA, GAUKHAR
Entity Type:Individual
Prefix:MS
First Name:GAUKHAR
Middle Name:
Last Name:OMARGALIYEVA
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 1:249-02 JERICHO TURNPIKE, SUITE 207
Mailing Address - Street 2:
Mailing Address - City:FLORAL PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11001
Mailing Address - Country:US
Mailing Address - Phone:718-635-2404
Mailing Address - Fax:
Practice Address - Street 1:249-02 JERICHO TURNPIKE, SUITE 207
Practice Address - Street 2:
Practice Address - City:FLORAL PARK
Practice Address - State:NY
Practice Address - Zip Code:11001
Practice Address - Country:US
Practice Address - Phone:718-635-2404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-31
Last Update Date:2017-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator