MEDICARE: AAA NATURALS INC.

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	374U00000X	Home Health Aide
2	261QA0600X	Adult Day Care Clinic/Center

General Provider Information

NPI Number	:	1326891938
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AAA NATURALS INC.

Provider Business Mailing Address
First Line	:	5 BREWSTER ST STE 527
Second Line	:
City	:	GLEN COVE
State	:	NY
Zip	:	11542-2549
Country	:	US
Telephone Number	:	718-757-0465
Fax Number	:

Provider Business Practice Location Address
First Line	:	2027 EMMONS AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-2781
Country	:	US
Telephone Number	:	718-757-0465
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. ELI YAKUBOV
Credential	:
Telephone Number	:	718-757-0465

Provider Enumeration Date	:	04/11/2024
Last Update Date	:	04/11/2024

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