Provider Demographics
NPI:1285899518
Name:AMINOV, MERIK (MERIK AMINOV)
Entity type:Individual
Prefix:MR
First Name:MERIK
Middle Name:
Last Name:AMINOV
Suffix:
Gender:M
Credentials:MERIK AMINOV
Other - Prefix:MR
Other - First Name:MERIK
Other - Middle Name:
Other - Last Name:AMINOV
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPA-C
Mailing Address - Street 1:1358 57TH ST APT 4
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11219-4668
Mailing Address - Country:US
Mailing Address - Phone:718-436-0525
Mailing Address - Fax:
Practice Address - Street 1:4802 10TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-2916
Practice Address - Country:US
Practice Address - Phone:718-283-7966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-25
Last Update Date:2008-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012488363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical