MEDICARE: DR. OLGA ABDUAKHADOV 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
1	2084P0800X	Psychiatry Physician	FR0435669172	NY

General Provider Information

NPI Number	:	1306287438
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. OLGA ABDUAKHADOV MD

Provider Business Mailing Address
First Line	:	2114 E 27TH ST FL 1
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-5012
Country	:	US
Telephone Number	:	347-267-0904
Fax Number	:

Provider Business Practice Location Address
First Line	:	2114 E 27TH ST FL 1
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-5012
Country	:	US
Telephone Number	:	347-267-0904
Fax Number	:

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

Provider Enumeration Date	:	07/17/2013
Last Update Date	:	07/17/2013

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