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General NPI Number Information
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NPI Number | 1891431391
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Entity Type | Individual
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Provider Name | NIGINA MIRAZIMOVA
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Gender | Female
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Dates
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Enumeration Date | 05/08/2022
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Last Update Date | 12/09/2024
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Provider Practice Location Address
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Address Line | 26 COURT ST STE 1210
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City | BROOKLYN
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State | NY
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Zip | 11242-2810
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Country | US
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Telephone | 718-679-7530
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Fax |
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Provider Business Mailing Address
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Address Line | 2652 CROPSEY AVE APT 16G
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City | BROOKLYN
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State | NY
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Zip | 11214-6732
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Country | US
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Telephone | 718-679-7530
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | F310737-01
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License Number State | NY
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