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General NPI Number Information
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NPI Number | 1215727680
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Entity Type | Individual
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Provider Name | OKSANA AVIZOVA
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Gender | Female
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Dates
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Enumeration Date | 05/08/2025
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Last Update Date | 12/20/2025
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Provider Practice Location Address
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Address Line | 360 MERRICK RD FL 1
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City | LYNBROOK
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State | NY
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Zip | 11563-2526
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Country | US
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Telephone | 516-887-3516
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Fax |
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Provider Business Mailing Address
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Address Line | 144 SAN JUAN AVE
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City | ALBERTSON
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State | NY
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Zip | 11507-1725
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Country | US
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Telephone | 917-400-0719
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 7294458
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 163WS0200X
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Taxonomy Name | School Registered Nurse
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License Number | 7294458
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License Number State | NY
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