MEDICARE: NATALIYA NAUMENKO

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	164W00000X	Licensed Practical Nurse	322953-1	NY
2	163W00000X	Registered Nurse	729269	NY

General Provider Information

NPI Number	:	1184098253
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATALIYA NAUMENKO

Provider Business Mailing Address
First Line	:	2818 W 8TH ST APT 4L
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11224-3366
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2821 W 12TH ST
Second Line	:	APT 3A
City	:	BROOKLYN
State	:	NY
Zip	:	11224-3109
Country	:	US
Telephone Number	:	718-419-2141
Fax Number	:

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

Provider Enumeration Date	:	11/30/2015
Last Update Date	:	08/20/2024

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