Provider Demographics
NPI:1679574941
Name:ARSLANOV, RENAT (MD)
Entity Type:Individual
Prefix:
First Name:RENAT
Middle Name:
Last Name:ARSLANOV
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 SAW MILL RIVER RD
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:NY
Mailing Address - Zip Code:10532-1533
Mailing Address - Country:US
Mailing Address - Phone:914-593-1606
Mailing Address - Fax:914-593-1790
Practice Address - Street 1:4350 VAN CORTLANDT PARK E
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10470-1875
Practice Address - Country:US
Practice Address - Phone:718-231-6565
Practice Address - Fax:718-231-8477
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2018-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP6775208000000X, 208M00000X
NY246229208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0247233Medicaid
NY513Z61Medicare PIN
NY0247233Medicaid