Provider Demographics
NPI:1003215732
Name:AKIVA MANAGEMENT GROUP INC
Entity type:Organization
Organization Name:AKIVA MANAGEMENT GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.O.O
Authorized Official - Prefix:MR
Authorized Official - First Name:VADIM
Authorized Official - Middle Name:
Authorized Official - Last Name:AGAFONOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-315-3615
Mailing Address - Street 1:1330 UTICA AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-5912
Mailing Address - Country:US
Mailing Address - Phone:917-463-9138
Mailing Address - Fax:347-713-4022
Practice Address - Street 1:1047 SURF AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11224-2810
Practice Address - Country:US
Practice Address - Phone:718-444-5125
Practice Address - Fax:718-444-1582
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-19
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No251S00000XAgenciesCommunity/Behavioral Health