MEDICARE: DIANA ARANBAYEVA

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	363A00000X	Physician Assistant	010838	NY

General Provider Information

NPI Number	:	1073787743
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIANA ARANBAYEVA

Provider Business Mailing Address
First Line	:	11211 69TH AVE
Second Line	:
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-3917
Country	:	US
Telephone Number	:	917-579-0634
Fax Number	:

Provider Business Practice Location Address
First Line	:	20811 HILLSIDE AVE
Second Line	:
City	:	QUEENS VILLAGE
State	:	NY
Zip	:	11427-1711
Country	:	US
Telephone Number	:	718-479-5017
Fax Number	:	718-479-0771

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

Provider Enumeration Date	:	04/14/2008
Last Update Date	:	04/14/2008

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Directions to “ DIANA ARANBAYEVA ” Practice Location

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