Odelya Tabibov, FNP
Nurse Practitioner, Family in Manhasset, NY. Individual provider (NPI-1).
NPI number1942945985
StatusActive
Last updated in NPPESMay 4, 2022
Details
- NPI
- 1942945985
- Entity type
- Individual (NPI-1)
- Name
- Odelya Tabibov
- Credential
- FNP
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- May 4, 2022
- Certification date
- May 4, 2022
- Last updated
- May 4, 2022
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - NURSE PRACTITIONER
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | F345304-01 | NY | Yes |
Practice location
300 Community DrManhasset, NY 11030-3816
Phone 516-562-0100
Mailing address
9946 64th AveRego Park, NY 11374-2645
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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