Provider Demographics
NPI:1104418987
Name:ARONOV, ROBERT (NP)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:ARONOV
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12325 82ND AVE APT 4J
Mailing Address - Street 2:
Mailing Address - City:KEW GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11415-1216
Mailing Address - Country:US
Mailing Address - Phone:347-273-3869
Mailing Address - Fax:
Practice Address - Street 1:12325 82ND AVE APT 4J
Practice Address - Street 2:
Practice Address - City:KEW GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11415-1216
Practice Address - Country:US
Practice Address - Phone:347-273-3869
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-03
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF309724-01363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology