Provider Demographics
NPI:1023876307
Name:KURBANOVA, FARIZA (RN)
Entity type:Individual
Prefix:
First Name:FARIZA
Middle Name:
Last Name:KURBANOVA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1850 OCEAN AVE APT E9
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-6220
Mailing Address - Country:US
Mailing Address - Phone:929-433-9340
Mailing Address - Fax:
Practice Address - Street 1:1850 OCEAN AVE APT E9
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-6220
Practice Address - Country:US
Practice Address - Phone:929-433-9340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-11
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY856984163WM0102X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn