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General NPI Number Information
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NPI Number | 1932612322
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Entity Type | Individual
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Provider Name | ARKADI MINTSIS PA
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Gender | Male
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Dates
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Enumeration Date | 11/08/2017
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Last Update Date | 11/08/2017
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Provider Practice Location Address
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Address Line | 2601 OCEAN PKWY
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City | BROOKLYN
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State | NY
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Zip | 11235-7745
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Country | US
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Telephone | 718-616-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 458 NEPTUNE AVE APT 3E
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City | BROOKLYN
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State | NY
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Zip | 11224-4312
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Country | US
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Telephone | 347-705-3066
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Fax |
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 021642
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License Number State | NY
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