Provider Demographics
NPI:1821697368
Name:NAYMANOV, RENAT
Entity Type:Individual
Prefix:
First Name:RENAT
Middle Name:
Last Name:NAYMANOV
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 1:2438 E 11TH ST APT 1B
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-5082
Mailing Address - Country:US
Mailing Address - Phone:347-228-5588
Mailing Address - Fax:
Practice Address - Street 1:4533 37TH ST
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101-1842
Practice Address - Country:US
Practice Address - Phone:347-228-5588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-24
Last Update Date:2020-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY824237620344600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes344600000XTransportation ServicesTaxi