Provider Demographics
NPI:1457086720
Name:KARIMOV, UMIDJON
Entity Type:Individual
Prefix:
First Name:UMIDJON
Middle Name:
Last Name:KARIMOV
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 1:6401 24TH AVE APT A4
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11204-3415
Mailing Address - Country:US
Mailing Address - Phone:347-764-2000
Mailing Address - Fax:
Practice Address - Street 1:6401 24TH AVE APT A4
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-3415
Practice Address - Country:US
Practice Address - Phone:347-764-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-20
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY353164902347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle