Provider Demographics
NPI:1720830615
Name:SADYKOVA, ROCHEL (MSN, FNP -C)
Entity Type:Individual
Prefix:
First Name:ROCHEL
Middle Name:
Last Name:SADYKOVA
Suffix:
Gender:F
Credentials:MSN, FNP -C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6519 BORDEN AVE FL MASPETH1
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11378-1630
Mailing Address - Country:US
Mailing Address - Phone:646-299-2226
Mailing Address - Fax:
Practice Address - Street 1:6519 BORDEN AVE FL MASPETH1
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11378-1630
Practice Address - Country:US
Practice Address - Phone:646-299-2226
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-03
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY737356163W00000X
NY353339363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse