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NPI Code Detail

MEDICARE: IZRAIL ABDURAKHMANOV MD

MEDICARE: IZRAIL ABDURAKHMANOV MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician324928NY
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1023638020
Entity Type Code : Individual
Provider Name (Legal Business Name) : IZRAIL ABDURAKHMANOV MD
Provider Business Mailing Address
First Line : 4102 13TH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11219-1389
Country : US
Telephone Number : 718-400-9988
Fax Number : 718-408-7433
Provider Business Practice Location Address
First Line : 4102 13TH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11219-1389
Country : US
Telephone Number : 718-400-9988
Fax Number : 718-408-7433
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/20/2020
Last Update Date : 03/02/2026

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