Provider Demographics
NPI:1154217305
Name:ARTANOV, VIACHESLAV (MS ED)
Entity type:Individual
Prefix:
First Name:VIACHESLAV
Middle Name:
Last Name:ARTANOV
Suffix:
Gender:M
Credentials:MS ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1684 W 10TH ST APT F12
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-1170
Mailing Address - Country:US
Mailing Address - Phone:205-435-0752
Mailing Address - Fax:
Practice Address - Street 1:1684 W 10TH ST APT F12
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-1170
Practice Address - Country:US
Practice Address - Phone:205-435-0752
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-16
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3041869174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist