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General NPI Number Information
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NPI Number | 1306013511
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Entity Type | Organization
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Legal Business Name | MIKHAIL VOLOKITIN MEDICAL P.C.
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Dates
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Enumeration Date | 05/15/2008
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Last Update Date | 05/15/2008
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Provider Practice Location Address
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Address Line | 50 W 97TH ST STE 1-B
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City | NEW YORK
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State | NY
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Zip | 10025-6053
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Country | US
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Telephone | 212-665-3200
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Fax | 212-665-4756
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Provider Business Mailing Address
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Address Line | 50 W 97TH ST STE 1-B
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City | NEW YORK
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State | NY
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Zip | 10025-6053
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Country | US
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Telephone | 212-665-3200
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Fax | 212-665-4756
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Authorized Official
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Title or Position | MANAGER
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Name | TATYANA VOLOKITIN
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Credential |
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Telephone | 212-665-3200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204D00000X
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Taxonomy Name | Neuromusculoskeletal Medicine & OMM Physician
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License Number | 205383
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License Number State | NY
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