MEDICARE: ZARRINA ISANOVA LMSW

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	104100000X	Social Worker	085379	NY

General Provider Information

NPI Number	:	1164792297
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZARRINA ISANOVA LMSW

Provider Business Mailing Address
First Line	:	10225 67TH DR
Second Line	:	APT 3F
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-2860
Country	:	US
Telephone Number	:	347-581-2409
Fax Number	:

Provider Business Practice Location Address
First Line	:	10225 67TH DR
Second Line	:	APT 3F
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-2860
Country	:	US
Telephone Number	:	347-581-2409
Fax Number	:

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

Provider Enumeration Date	:	01/05/2012
Last Update Date	:	01/05/2012

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