Provider Demographics
NPI:1710570981
Name:ARONOV, SHOSHANA (SPECIALIST)
Entity Type:Individual
Prefix:
First Name:SHOSHANA
Middle Name:
Last Name:ARONOV
Suffix:
Gender:F
Credentials:SPECIALIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6625 103RD ST APT 5G
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-2020
Mailing Address - Country:US
Mailing Address - Phone:347-925-5976
Mailing Address - Fax:
Practice Address - Street 1:6625 103RD ST APT 5G
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-2020
Practice Address - Country:US
Practice Address - Phone:347-925-5976
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-18
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1462081211174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist