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General NPI Number Information
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NPI Number | 1457823049
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Entity Type | Individual
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Provider Name | ALEXANDRA GADAYEVA
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Gender | Female
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Dates
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Enumeration Date | 12/20/2018
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Last Update Date | 12/20/2018
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Provider Practice Location Address
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Address Line | 5501 94TH ST
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City | FLUSHING
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State | NY
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Zip | 11373
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Country | US
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Telephone | 718-271-1021
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Fax |
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Provider Business Mailing Address
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Address Line | 63109 SAUNDERS ST APT A13
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City | REGO PARK
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State | NY
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Zip | 11374-3128
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Country | US
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Telephone | 917-584-8618
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 023234
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License Number State | NY
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