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NPI Code Detail

MEDICARE: YAEL NISANOV

MEDICARE: YAEL NISANOV
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
1104100000XSocial Worker

General Provider Information

NPI Number : 1245192020
Entity Type Code : Individual
Provider Name (Legal Business Name) : YAEL NISANOV
Provider Business Mailing Address
First Line : 1268 E 14TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11230-5241
Country : US
Telephone Number : 718-382-0045
Fax Number :
Provider Business Practice Location Address
First Line : 1268 E 14TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11230-5241
Country : US
Telephone Number : 718-382-0045
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2025
Last Update Date : 12/01/2025

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Directions to “ YAEL NISANOV ” Practice Location

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