MEDICARE: YEVGENIYA KARMAZIN MEDICAL PC

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	174400000X	Specialist	198112	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	:	1790775070
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YEVGENIYA KARMAZIN MEDICAL PC

Provider Business Mailing Address
First Line	:	2 BIRCH DR
Second Line	:
City	:	HEWLETT
State	:	NY
Zip	:	11557-2615
Country	:	US
Telephone Number	:	516-374-0974
Fax Number	:	516-374-0978

Provider Business Practice Location Address
First Line	:	3084 BRIGHTON 13TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-5608
Country	:	US
Telephone Number	:	718-891-5100
Fax Number	:	718-891-8810

Authorized Official
Title or Position	:	PRESIDENT
Name	:	YEVGENIYA KARMAZIN
Credential	:	M.D.
Telephone Number	:	718-891-5100

Provider Enumeration Date	:	10/26/2005
Last Update Date	:	04/25/2008

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