Healthcare Provider Details

I. General information

NPI: 1922981760
Provider Name (Legal Business Name): XCLUSIVERIDE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2025
Last Update Date: 07/29/2025
Certification Date: 07/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2751 OCEAN AVE LOWR
BROOKLYN NY
11229-4707
US

IV. Provider business mailing address

2751 OCEAN AVE LOWR
BROOKLYN NY
11229-4707
US

V. Phone/Fax

Practice location:
  • Phone: 347-821-0248
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code344600000X
TaxonomyTaxi
License Number
License Number State

VIII. Authorized Official

Name: AZIZBEK RAKHMATULLAEV
Title or Position: PRESIDENT
Credential:
Phone: 347-821-0248