Healthcare Provider Details

I. General information

NPI: 1649182262
Provider Name (Legal Business Name): MOHINABONU ASROROVA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

704 AVENUE X
BROOKLYN NY
11235-6121
US

IV. Provider business mailing address

2455 HARING ST APT 4G
BROOKLYN NY
11235-1817
US

V. Phone/Fax

Practice location:
  • Phone: 718-676-6116
  • Fax:
Mailing address:
  • Phone: 929-300-4826
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: