Individual provider · NPI-1

Mark Abdurakhmanov

Student in an Organized Health Care Education/Training Program · Stony Brook, NY

NPI number1265370076
StatusActive
Last updated in NPPESMar 23, 2026

Details

NPI
1265370076
Entity type
Individual (NPI-1)
Name
Mark Abdurakhmanov
Sex
Male
Sole proprietor
No
Enumeration date
Mar 23, 2026
Certification date
Mar 23, 2026
Last updated
Mar 23, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
390200000X Student in an Organized Health Care Education/Training Program––Yes

Practice location

101 County Rd 97
Stony Brook, NY 11794-0001

Phone 631-689-8333

Mailing address

101 County Rd 97
Stony Brook, NY 11794-0001

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