Provider Information for 1114227782
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Mr. ALEKSANDR RAYNOV LCSW
Sex: Male
NPI: 1114227782
Last Updated: 2012-08-07
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1114227782 | ||||||||
| Enumeration Date | 2010-10-28 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 1083 MCDONALD AVE BROOKLYN, NY 11230-2651 United States Phone: 718-421-7444 | Fax: | ||||||||
| Primary Practice Address | 1083 MCDONALD AVE BROOKLYN, NY 11230-2651 United States Phone: 718-421-7444 | Fax: | ||||||||
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