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General NPI Number Information
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NPI Number | 1962030791
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Entity Type | Individual
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Provider Name | ULVIYYA GASIMOVA MD
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Gender | Female
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Dates
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Enumeration Date | 03/28/2020
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Last Update Date | 07/25/2025
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Provider Practice Location Address
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Address Line | 1 MEDICAL CENTER DR
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City | LEBANON
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State | NH
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Zip | 03756-0001
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Country | US
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Telephone | 857-234-4639
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Fax |
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Provider Business Mailing Address
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Address Line | 343 MOUNT SUPPORT RD UNIT 355
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City | LEBANON
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State | NH
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Zip | 03766-2853
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Country | US
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Telephone | 857-234-4639
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | MED-PHYS-LIC-144230
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License Number State | MT
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