Healthcare Provider Details
I. General information
NPI: 1881288421
Provider Name (Legal Business Name): RELIEF LEAF NP FAMILY HEALTH PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/24/2021
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
14128 72ND CRES
FLUSHING NY
11367-2330
US
IV. Provider business mailing address
14128 72ND CRES
FLUSHING NY
11367-2330
US
V. Phone/Fax
- Phone: 646-919-1871
- Fax: 575-209-2717
- Phone: 646-919-1871
- Fax: 575-209-2717
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ALEX
RAKHMINOV
Title or Position: OWNER
Credential:
Phone: 646-919-1871