Julie Alexa Niyazov
Specialist in Fresh Meadows, NY. Individual provider (NPI-1).
NPI number1003166174
StatusActive
Last updated in NPPESSep 14, 2012
Details
- NPI
- 1003166174
- Entity type
- Individual (NPI-1)
- Name
- Julie Alexa Niyazov
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 14, 2012
- Last updated
- Sep 14, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174400000X | Specialist | 659121121 | NY | Yes |
Practice location
75-04 171 StreetFresh Meadows, NY 11366
Phone 917-903-9616
Mailing address
75-04 171 StreetFresh Meadows, NY 11366
Phone 917-903-9616
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