MEDICARE: LIYA KRIKHELI NP

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	363LF0000X	Family Nurse Practitioner	F353322-01	NY

General Provider Information

NPI Number	:	1356101406
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LIYA KRIKHELI NP

Provider Business Mailing Address
First Line	:	68 HICKORY LN
Second Line	:
City	:	ROSLYN HEIGHTS
State	:	NY
Zip	:	11577-2106
Country	:	US
Telephone Number	:	347-854-8262
Fax Number	:

Provider Business Practice Location Address
First Line	:	68 HICKORY LN
Second Line	:
City	:	ROSLYN HEIGHTS
State	:	NY
Zip	:	11577-2106
Country	:	US
Telephone Number	:	347-854-8262
Fax Number	:

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

Provider Enumeration Date	:	03/19/2024
Last Update Date	:	03/19/2024

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Directions to “ LIYA KRIKHELI NP” Practice Location

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