MEDICARE: KRISTINE ARUTYUNOVA

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	363LW0102X	Women's Health Nurse Practitioner	F421307-1	NY

General Provider Information

NPI Number	:	1972022291
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTINE ARUTYUNOVA

Provider Business Mailing Address
First Line	:	2055 OCEAN AVE APT 3C
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-7311
Country	:	US
Telephone Number	:	718-290-6403
Fax Number	:

Provider Business Practice Location Address
First Line	:	2829 OCEAN PKWY STE C
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-7869
Country	:	US
Telephone Number	:	718-743-5300
Fax Number	:

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

Provider Enumeration Date	:	09/18/2017
Last Update Date	:	09/18/2017

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Directions to “ KRISTINE ARUTYUNOVA ” Practice Location

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