Provider Demographics
NPI:1750318721
Name:ARONBAYEV, JONATHAN (MD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:
Last Name:ARONBAYEV
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 1:14353 HOOVER AVE
Mailing Address - Street 2:
Mailing Address - City:BRIARWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11435-2137
Mailing Address - Country:US
Mailing Address - Phone:718-657-2260
Mailing Address - Fax:347-233-3362
Practice Address - Street 1:14353 HOOVER AVE
Practice Address - Street 2:
Practice Address - City:BRIARWOOD
Practice Address - State:NY
Practice Address - Zip Code:11435-2137
Practice Address - Country:US
Practice Address - Phone:718-657-2260
Practice Address - Fax:347-266-6632
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY192886207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01439550Medicaid
NY01439550Medicaid
NY69H611Medicare ID - Type Unspecified