Provider Demographics
NPI:1437973419
Name:AMINOVA, MILANA
Entity type:Individual
Prefix:
First Name:MILANA
Middle Name:
Last Name:AMINOVA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6433 99TH ST APT 2J
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-3541
Mailing Address - Country:US
Mailing Address - Phone:347-659-7160
Mailing Address - Fax:
Practice Address - Street 1:6433 99TH ST APT 2J
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-3541
Practice Address - Country:US
Practice Address - Phone:347-659-7160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-14
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032934363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant