Individual
RADION NIYAZOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
15640C CROSSBAY BLVD, HOWARD BEACH, NY 11414-2771
(718) 406-7666
Mailing address
15640C CROSSBAY BLVD, HOWARD BEACH, NY 11414-2771
(718) 406-7666
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NA
NO FAULT
—
Enumeration date
12/29/2020
Last updated
12/29/2020
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