MEDICARE: ANNA BANGIYEVA

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	357166	NY
2	208VP0000X	Pain Medicine Physician	357166	NY

General Provider Information

NPI Number	:	1487582060
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNA BANGIYEVA

Provider Business Mailing Address
First Line	:	63164 ALDERTON ST
Second Line	:
City	:	REGO PARK
State	:	NY
Zip	:	11374-3945
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7909 NORTHERN BLVD
Second Line	:
City	:	JACKSON HEIGHTS
State	:	NY
Zip	:	11372-1223
Country	:	US
Telephone Number	:	347-836-5824
Fax Number	:

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

Provider Enumeration Date	:	05/12/2026
Last Update Date	:	05/12/2026

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Directions to “ ANNA BANGIYEVA ” Practice Location

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