Provider Demographics
NPI:1316436124
Name:NAZAR, ESTEE
Entity type:Individual
Prefix:
First Name:ESTEE
Middle Name:
Last Name:NAZAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ESTEE
Other - Middle Name:
Other - Last Name:MACANIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:19 LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11023-2313
Mailing Address - Country:US
Mailing Address - Phone:516-244-3103
Mailing Address - Fax:
Practice Address - Street 1:19 LOCUST ST
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11023-2313
Practice Address - Country:US
Practice Address - Phone:516-244-3103
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-07
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY959268174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist