Provider Demographics
NPI:1568483097
Name:ISKHAKOV, GALINA (LCSW, 'R')
Entity type:Individual
Prefix:MRS
First Name:GALINA
Middle Name:
Last Name:ISKHAKOV
Suffix:
Gender:F
Credentials:LCSW, 'R'
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7009 AUSTIN ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-4700
Mailing Address - Country:US
Mailing Address - Phone:718-263-4008
Mailing Address - Fax:718-263-3133
Practice Address - Street 1:70-09 AUSTIN STREET
Practice Address - Street 2:SUITE 205
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-4700
Practice Address - Country:US
Practice Address - Phone:718-263-4008
Practice Address - Fax:718-263-3133
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY071089, 'R'174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist