Healthcare Provider Details

I. General information

NPI: 1720942220
Provider Name (Legal Business Name): ALEXANDRA ISKHAKOVA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 12/10/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

94-98 MANHATTAN AVENUE
BROOKLYN NY
11206
US

IV. Provider business mailing address

44 W 28TH ST FL 5
NEW YORK NY
10001-4212
US

V. Phone/Fax

Practice location:
  • Phone: 718-388-0390
  • Fax:
Mailing address:
  • Phone: 866-246-8259
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number129038
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: