Provider Demographics
NPI:1639777600
Name:SAFAEV, AZIZ
Entity Type:Individual
Prefix:
First Name:AZIZ
Middle Name:
Last Name:SAFAEV
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 1:3505 STATE ROUTE 22 AND 3 APT 9
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:45140-3503
Mailing Address - Country:US
Mailing Address - Phone:513-487-8747
Mailing Address - Fax:
Practice Address - Street 1:3505 STATE ROUTE 22 AND 3 APT 9
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:OH
Practice Address - Zip Code:45140-3503
Practice Address - Country:US
Practice Address - Phone:513-487-8747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-13
Last Update Date:2020-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty