Provider Demographics
NPI:1235685603
Name:BARAKAYEV, ARNOLD
Entity Type:Individual
Prefix:
First Name:ARNOLD
Middle Name:
Last Name:BARAKAYEV
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7030 UTOPIA PKWY
Mailing Address - Street 2:
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11365-3434
Mailing Address - Country:US
Mailing Address - Phone:347-598-3401
Mailing Address - Fax:
Practice Address - Street 1:7130 MYRTLE AVE
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:NY
Practice Address - Zip Code:11385-7260
Practice Address - Country:US
Practice Address - Phone:718-456-0100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-26
Last Update Date:2016-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY062130183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist