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NPI Code Detail

MEDICARE: LEYSAN MINGALIEVA

MEDICARE: LEYSAN MINGALIEVA
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
1171M00000XCase Manager/Care Coordinator

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1629783485
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEYSAN MINGALIEVA
Provider Business Mailing Address
First Line : 2334 E 28TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11229-5034
Country : US
Telephone Number : 347-922-4349
Fax Number :
Provider Business Practice Location Address
First Line : 2334 E 28TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11229-5034
Country : US
Telephone Number : 347-922-4349
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/17/2023
Last Update Date : 01/17/2023

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Directions to “ LEYSAN MINGALIEVA ” Practice Location

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