Provider Demographics
NPI:1336934793
Name:BABAYEV, TONY
Entity type:Individual
Prefix:
First Name:TONY
Middle Name:
Last Name:BABAYEV
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:624 DRUMGOOLE RD E
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312-3308
Mailing Address - Country:US
Mailing Address - Phone:347-593-4130
Mailing Address - Fax:
Practice Address - Street 1:1702 AVENUE Z STE 2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-3705
Practice Address - Country:US
Practice Address - Phone:347-593-4130
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-14
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ41011629171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach