Provider Demographics
NPI:1912667445
Name:NURMURADOVA, GULJAN
Entity Type:Individual
Prefix:
First Name:GULJAN
Middle Name:
Last Name:NURMURADOVA
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 1:209 WOODLAND AVE
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06002-1808
Mailing Address - Country:US
Mailing Address - Phone:122-480-5020
Mailing Address - Fax:
Practice Address - Street 1:100 SYCAMORE ST UNIT 2
Practice Address - Street 2:
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-4508
Practice Address - Country:US
Practice Address - Phone:860-633-6022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-24
Last Update Date:2021-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty