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NPI Code Detail

MEDICARE: FAINA IZGIYAYEV

MEDICARE: FAINA IZGIYAYEV
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
11041C0700XClinical Social Worker107594NY

General Provider Information

NPI Number : 1205788247
Entity Type Code : Individual
Provider Name (Legal Business Name) : FAINA IZGIYAYEV
Provider Business Mailing Address
First Line : 2357 E 19TH ST APT 1
Second Line :
City : BROOKLYN
State : NY
Zip : 11229-4762
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2255 CROPSEY AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11214-5705
Country : US
Telephone Number : 718-266-5858
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/12/2026
Last Update Date : 02/12/2026

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