Healthcare Provider Details

I. General information

NPI: 1609312156
Provider Name (Legal Business Name): MICHAEL ADASHEV
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2017
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 E 70TH ST
NEW YORK NY
10021-4898
US

IV. Provider business mailing address

535 E 70TH ST
NEW YORK NY
10021-4898
US

V. Phone/Fax

Practice location:
  • Phone: 212-606-1000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number024459
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number024459
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: