Provider Demographics
NPI:1447856554
Name:UMAROVA, FOTIMA
Entity type:Individual
Prefix:
First Name:FOTIMA
Middle Name:
Last Name:UMAROVA
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 1:3074 BRIGHTON 14TH ST APT B2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-5541
Mailing Address - Country:US
Mailing Address - Phone:347-543-0116
Mailing Address - Fax:
Practice Address - Street 1:3074 BRIGHTON 14TH ST APT B2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-5541
Practice Address - Country:US
Practice Address - Phone:347-543-0116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-05
Last Update Date:2020-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist