| Doctor Name: | MS. MZIA KVIRKVELIA |
| NPI Number: | 1063817989 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 682856 |
| Business Practice Address: | 2811 Queens Plz N 5th Floor Long Island City, NY - 111014008 |
| Business Phone Number: | 7183918300 |
| Business Fax Number: | |
| Mailing Address: | 21 Holcomb Ave, STAMFORD |
| State: | CT |
| Postal Code: | 069062412 |
| Phone Number: | 9172098522 |
| Fax Number: | |
| NPI Enumeration Date: | 11/04/2014 |
| NPI Last Update Date: | 11/04/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WS0200X |
| License Number: | 682856 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |