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NPI Code Detail

MEDICARE: ARKADY MIGDALOVICH P.T.

MEDICARE: ARKADY MIGDALOVICH P.T.
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
1208100000XPhysical Medicine & Rehabilitation Physician017757NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
111-3552139OTHERNYMULTIPLAN
211-3552139OTHERNYUNITED HEALTH CARE
311-3552139OTHERNY1199 NBF
4017757OTHERNYHIP
5QB6251OTHERNYEMPIRE BC/BS
6N84089OTHERNYHEALTH NET
7MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
86699137OTHERNYGHI
9000160820201OTHERNYHEALTH PLUS

General Provider Information

NPI Number : 1871557538
Entity Type Code : Individual
Provider Name (Legal Business Name) : ARKADY MIGDALOVICH P.T.
Provider Business Mailing Address
First Line : 90 RIDGE AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10304-1421
Country : US
Telephone Number : 917-597-2172
Fax Number : 718-980-3619
Provider Business Practice Location Address
First Line : 8712 4TH AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11209-5110
Country : US
Telephone Number : 718-680-1600
Fax Number : 718-680-4473
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/12/2006
Last Update Date : 09/12/2016

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