MEDICARE: SYUZANA ARONOVA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist

General Provider Information

NPI Number	:	1205254778
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SYUZANA ARONOVA

Provider Business Mailing Address
First Line	:	10225 67TH DR
Second Line	:	APT. 2T
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-2860
Country	:	US
Telephone Number	:	917-608-2751
Fax Number	:

Provider Business Practice Location Address
First Line	:	10225 67TH DR
Second Line	:	APT. 2T
City	:	FOREST HILLS
State	:	NY
Zip	:	11375-2860
Country	:	US
Telephone Number	:	917-608-2751
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/02/2014
Last Update Date	:	04/02/2014

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