Provider Demographics
NPI:1881887941
Name:NAROV, MIKHAIL
Entity type:Individual
Prefix:
First Name:MIKHAIL
Middle Name:
Last Name:NAROV
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 1:15 DEER COVE RD
Mailing Address - Street 2:
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01902-3119
Mailing Address - Country:US
Mailing Address - Phone:781-592-8952
Mailing Address - Fax:617-531-2050
Practice Address - Street 1:15 DEER COVE RD
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01902-3119
Practice Address - Country:US
Practice Address - Phone:781-592-8952
Practice Address - Fax:617-531-2050
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-22
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALV13960172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver