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General NPI Number Information
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NPI Number | 1003220351
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Entity Type | Individual
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Provider Name | YULIA NAUMOVA OD
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Gender | Female
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Dates
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Enumeration Date | 06/15/2014
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Last Update Date | 12/23/2019
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Provider Practice Location Address
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Address Line | 400 PARK PL
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City | SECAUCUS
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State | NJ
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Zip | 07094-3654
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Country | US
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Telephone | 201-421-9321
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Fax |
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Provider Business Mailing Address
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Address Line | 234 KNOX AVE UNIT B
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City | CLIFFSIDE PARK
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State | NJ
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Zip | 07010-2510
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Country | US
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Telephone | 201-421-9321
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Fax | 201-945-3470
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPC 5037
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 27OA00652600
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License Number State | NJ
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