MEDICARE: DR. MIKHAIL PAIKIN M.D.,D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	170100000X	Ph.D. Medical Genetics	223328	NY
2	207Q00000X	Family Medicine Physician	223328	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376587246
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MIKHAIL PAIKIN M.D.,D.O.

Provider Business Mailing Address
First Line	:	288 SAND LN
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10305-4512
Country	:	US
Telephone Number	:	718-541-2939
Fax Number	:

Provider Business Practice Location Address
First Line	:	288 SAND LN
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10305-4512
Country	:	US
Telephone Number	:	718-541-2939
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/15/2006
Last Update Date	:	05/07/2019

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