Healthcare Provider Details

I. General information

NPI: 1568372860
Provider Name (Legal Business Name): MS. VIOLETTA KURAYEVA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

300 OLD COUNTRY RD STE 101
MINEOLA NY
11501-4112
US

IV. Provider business mailing address

10255 67TH DR APT 5A
FOREST HILLS NY
11375-2826
US

V. Phone/Fax

Practice location:
  • Phone: 516-400-2988
  • Fax:
Mailing address:
  • Phone: 347-612-5843
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF354605
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: