Healthcare Provider Details

I. General information

NPI: 1942039680
Provider Name (Legal Business Name): AYLA A DADASHEVA NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2024
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 E BOSTON POST RD
MAMARONECK NY
10543-3757
US

IV. Provider business mailing address

501 E BOSTON POST RD
MAMARONECK NY
10543-3757
US

V. Phone/Fax

Practice location:
  • Phone: 914-634-1692
  • Fax:
Mailing address:
  • Phone: 914-634-1692
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF353823
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: