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General NPI Number Information
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NPI Number | 1083640478
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Entity Type | Individual
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Provider Name | SERGEY ZHITNIKOV MD
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Gender | Male
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Dates
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Enumeration Date | 06/25/2006
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Last Update Date | 03/19/2025
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Provider Practice Location Address
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Address Line | 1 MEDICAL CENTER BLVD ACP 11, SUITE 326
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City | CHESTER
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State | PA
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Zip | 19013-3902
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Country | US
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Telephone | 610-619-8450
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Fax | 610-619-8451
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Provider Business Mailing Address
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Address Line | ONE MEDICAL CENTER BLVD POB 11, SUITE 326
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City | UPLAND
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State | PA
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Zip | 19013-3901
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Country | US
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Telephone | 610-619-8450
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Fax | 610-619-8451
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 044063
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MD450442
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License Number State | PA
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