Provider Demographics
NPI:1184098253
Name:NAUMENKO, NATALIYA
Entity type:Individual
Prefix:
First Name:NATALIYA
Middle Name:
Last Name:NAUMENKO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2818 W 8TH ST APT 4L
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11224-3366
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2821 W 12TH ST
Practice Address - Street 2:APT 3A
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11224-3109
Practice Address - Country:US
Practice Address - Phone:718-419-2141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-30
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY322953-1164W00000X
NY729269163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse