MEDICARE: PERIZAT ADYLBEKOVA

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	:	1457147514
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PERIZAT ADYLBEKOVA

Provider Business Mailing Address
First Line	:	6580 E MCDOWELL RD UNIT 2242
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85257-0029
Country	:	US
Telephone Number	:	716-320-0303
Fax Number	:

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

Authorized Official
Title or Position	:	OWNER OF ENTITY
Name	:	PERIZAT ADYLBEKOVA
Credential	:
Telephone Number	:	716-320-0303

Provider Enumeration Date	:	04/16/2025
Last Update Date	:	04/16/2025

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