MEDICARE: PERIZAT ADYLBEKOVA RDN

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
1	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1033955588
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PERIZAT ADYLBEKOVA RDN

Provider Business Mailing Address
First Line	:	11 ROBIN RD
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14228-1115
Country	:	US
Telephone Number	:	716-320-0303
Fax Number	:

Provider Business Practice Location Address
First Line	:	11 ROBIN RD
Second Line	:
City	:	BUFFALO
State	:	NY
Zip	:	14228-1115
Country	:	US
Telephone Number	:	716-320-0303
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/03/2024
Last Update Date	:	07/03/2024

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