Provider Demographics
NPI:1437030533
Name:ISKANDAROVA, GULSARA
Entity type:Individual
Prefix:
First Name:GULSARA
Middle Name:
Last Name:ISKANDAROVA
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 1:4348 ROSCOMMON WAY
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45440-3871
Mailing Address - Country:US
Mailing Address - Phone:937-239-4877
Mailing Address - Fax:
Practice Address - Street 1:4348 ROSCOMMON WAY
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45440-3871
Practice Address - Country:US
Practice Address - Phone:937-239-4877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-08
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHTK0454053747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant