Active NPI
Marina Dzhurayeva
- Health Educator
- Rego Park, NY
National Provider Identifier
1679016430
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Educator
- License
- 642523121
- Practice address
- 9966 65TH Ave
Rego Park, NY 11374-3653 - Phone
- (347) 527-8408
- NPI assigned
- Nov 28, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Educator | 174H00000X | 642523121 | NY | Primary |
Addresses
Primary practice location
9966 65TH Ave
Rego Park, NY 11374-3653
Mailing address
9966 65TH Ave
Rego Park, NY 11374-3653
Phone (347) 527-8408
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 642523121 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 642523121 | NY | MD | Health Educator |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1480291200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1480291200000",
"number": "1679016430",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9966 65TH AVE",
"city": "REGO PARK",
"state": "NY",
"postal_code": "113743653",
"telephone_number": "347-527-8408"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9966 65TH AVE",
"city": "REGO PARK",
"state": "NY",
"postal_code": "113743653",
"telephone_number": "347-527-8408"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DZHURAYEVA",
"first_name": "MARINA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-11-28",
"last_updated": "2016-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "174H00000X",
"taxonomy_group": "",
"desc": "Health Educator",
"state": "NY",
"license": "642523121",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "642523121",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rego Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.