Provider Demographics
NPI:1003220351
Name:NAUMOVA, YULIA (OD)
Entity type:Individual
Prefix:
First Name:YULIA
Middle Name:
Last Name:NAUMOVA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:234 KNOX AVE UNIT B
Mailing Address - Street 2:
Mailing Address - City:CLIFFSIDE PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07010-2510
Mailing Address - Country:US
Mailing Address - Phone:201-421-9321
Mailing Address - Fax:201-945-3470
Practice Address - Street 1:400 PARK PL
Practice Address - Street 2:
Practice Address - City:SECAUCUS
Practice Address - State:NJ
Practice Address - Zip Code:07094-3654
Practice Address - Country:US
Practice Address - Phone:201-421-9321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-15
Last Update Date:2019-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 5037152W00000X
NJ27OA00652600152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist