MEDICARE: RAFINA BAKHARAMOVA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	710060	NY
2	174400000X	Specialist

General Provider Information

NPI Number	:	1053179101
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAFINA BAKHARAMOVA

Provider Business Mailing Address
First Line	:	2023 W 7TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11223-3730
Country	:	US
Telephone Number	:	347-909-6279
Fax Number	:

Provider Business Practice Location Address
First Line	:	2023 W 7TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11223-3730
Country	:	US
Telephone Number	:	347-909-6279
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/12/2024
Last Update Date	:	04/10/2026

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