Healthcare Provider Details

I. General information

NPI: 1346028107
Provider Name (Legal Business Name): ANNA VOLKOV FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2023
Last Update Date: 09/12/2026
Certification Date: 09/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11205 QUEENS BLVD STE B
FOREST HILLS NY
11375-8311
US

IV. Provider business mailing address

11205 QUEENS BLVD STE B
FOREST HILLS NY
11375-8311
US

V. Phone/Fax

Practice location:
  • Phone: 718-740-5545
  • Fax:
Mailing address:
  • Phone: 718-740-5545
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF352401
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: