Provider Demographics
NPI:1407688823
Name:KANDOVA, VIOLETA (FNP)
Entity type:Individual
Prefix:
First Name:VIOLETA
Middle Name:
Last Name:KANDOVA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108-49 63RD AVE
Mailing Address - Street 2:APT 4 B
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375
Mailing Address - Country:US
Mailing Address - Phone:646-267-0252
Mailing Address - Fax:
Practice Address - Street 1:626 REXCORP PLAZA
Practice Address - Street 2:
Practice Address - City:UNIONDALE
Practice Address - State:NY
Practice Address - Zip Code:11556
Practice Address - Country:US
Practice Address - Phone:718-255-7368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-15
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY586586363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily