Rena Fazilova
Registered Nurse in Long Island City, NY. Individual provider (NPI-1).
NPI number1114721990
StatusActive
Last updated in NPPESApr 2, 2025
Details
- NPI
- 1114721990
- Entity type
- Individual (NPI-1)
- Name
- Rena Fazilova
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Apr 2, 2025
- Certification date
- Apr 2, 2025
- Last updated
- Apr 2, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163W00000X | Registered Nurse | 982772 | NY | Yes |
Practice location
2811 Queens Plz N Fl 5Long Island City, NY 11101-4172
Phone 718-391-8300
Mailing address
14135 78th Rd Apt 2mFlushing, NY 11367-3341
Phone 347-462-5220
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