Provider Demographics
NPI:1063237097
Name:DEKHKANOVA, NADEZHDA
Entity type:Individual
Prefix:MISS
First Name:NADEZHDA
Middle Name:
Last Name:DEKHKANOVA
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 1:13507 CROSSBAY BLVD FL 1B
Mailing Address - Street 2:
Mailing Address - City:OZONE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11417-2801
Mailing Address - Country:US
Mailing Address - Phone:718-535-0635
Mailing Address - Fax:718-297-1112
Practice Address - Street 1:13507 CROSSBAY BLVD FL 1B
Practice Address - Street 2:
Practice Address - City:OZONE PARK
Practice Address - State:NY
Practice Address - Zip Code:11417-2801
Practice Address - Country:US
Practice Address - Phone:718-535-0635
Practice Address - Fax:718-297-1112
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-15
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies