Provider Demographics
NPI:1962907584
Name:HLODAN, RUSLANA
Entity type:Individual
Prefix:
First Name:RUSLANA
Middle Name:
Last Name:HLODAN
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 1:1414 W 5TH ST APT C8
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-4028
Mailing Address - Country:US
Mailing Address - Phone:347-455-4689
Mailing Address - Fax:
Practice Address - Street 1:1414 W 5TH ST APT C8
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-4028
Practice Address - Country:US
Practice Address - Phone:347-455-4689
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-26
Last Update Date:2018-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY740164163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health