Provider Demographics
NPI:1265394787
Name:ABDUSAMADOV, ZULFIYA
Entity type:Individual
Prefix:
First Name:ZULFIYA
Middle Name:
Last Name:ABDUSAMADOV
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 1:1619 83RD ST APT 2R
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-2155
Mailing Address - Country:US
Mailing Address - Phone:917-328-2871
Mailing Address - Fax:
Practice Address - Street 1:1619 83RD ST APT 2R
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-2155
Practice Address - Country:US
Practice Address - Phone:917-328-2871
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-12-02
Last Update Date:2025-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician