Healthcare Provider Details

I. General information

NPI: 1497262810
Provider Name (Legal Business Name): GALINA MURDAKH RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2018
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15023 78TH RD
FLUSHING NY
11367-3539
US

IV. Provider business mailing address

15023 78TH RD
FLUSHING NY
11367-3539
US

V. Phone/Fax

Practice location:
  • Phone: 718-607-8637
  • Fax:
Mailing address:
  • Phone: 718-607-8637
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number669757
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: