Provider Demographics
NPI:1881045979
Name:ABDUKADYROVA, KAMILA
Entity type:Individual
Prefix:
First Name:KAMILA
Middle Name:
Last Name:ABDUKADYROVA
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 1:2427 E 29TH ST
Mailing Address - Street 2:APT 2B
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-1949
Mailing Address - Country:US
Mailing Address - Phone:718-373-8060
Mailing Address - Fax:
Practice Address - Street 1:2427 E 29TH ST
Practice Address - Street 2:APT 2B
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-1949
Practice Address - Country:US
Practice Address - Phone:718-373-8060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-29
Last Update Date:2016-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY930850151174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist