Healthcare Provider Details
I. General information
NPI: 1326891938
Provider Name (Legal Business Name): AAA NATURALS INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/11/2024
Last Update Date: 04/11/2024
Certification Date: 04/11/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2027 EMMONS AVE
BROOKLYN NY
11235-2781
US
IV. Provider business mailing address
5 BREWSTER ST STE 527
GLEN COVE NY
11542-2549
US
V. Phone/Fax
- Phone: 718-757-0465
- Fax:
- Phone: 718-757-0465
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA0600X |
| Taxonomy | Adult Day Care Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 374U00000X |
| Taxonomy | Home Health Aide |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
ELI
YAKUBOV
Title or Position: PRESIDENT
Credential:
Phone: 718-757-0465