Individual
MR. ELCHIN RAFAILOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LIVERY CAR SERVICE
Contact information
Practice address
1659 BATH AVE, BROOKLYN, NY 11214-4509
(212) 920-0133
Mailing address
1659 BATH AVE, BROOKLYN, NY 11214
Taxonomy
Speciality
Code
Description
License number
State
405300000X
Prevention Professional
Primary
B02920
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47-4929209
—
NY
Enumeration date
05/04/2017
Last updated
05/04/2017
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