Individual
ANASTASIA V NOVIKOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2148 OCEAN AVE STE 302, BROOKLYN, NY 11229-1484
(718) 375-2505
Mailing address
1820 E 13TH ST APT 5L, BROOKLYN, NY 11229-2823
(347) 634-1759
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2620285
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
885649008
DRIVER LICENSE
NY
Enumeration date
08/27/2021
Last updated
08/27/2021
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