Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 27OA00652600 | NJ |
N | 152W00000X | Optometrist | OPC 5037 | FL |
NPI | 1003220351 |
---|---|
Provider Name | Yulia Naumova |
First Address | Cliffside Park, NJ 07010-2510 |
Second Address | Secaucus, NJ 07094-3654 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2014 |
Last Update Date | 23/12/2019 |