Provider Demographics
NPI:1982388435
Name:YAGUDAYEVA, MALKA
Entity Type:Individual
Prefix:
First Name:MALKA
Middle Name:
Last Name:YAGUDAYEVA
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 1:10540 62ND RD APT 7K
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-1129
Mailing Address - Country:US
Mailing Address - Phone:646-221-2525
Mailing Address - Fax:
Practice Address - Street 1:10540 62ND RD APT 7K
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-1129
Practice Address - Country:US
Practice Address - Phone:646-221-2525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY611599163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse