Physician Compare National (NPI:1669569216)

HEALTHCARE PROVIDER: ANRI ARONOVITCH KISSILENKO M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1669569216
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8426242553
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20111129000145
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	KISSILENKO
	Individual professional last name
Provider First Name	ANRI
	Individual professional first name
Provider Middle Name	A
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1990
	Individual professional's medical school graduation year
Primary Specialty	PSYCHIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	12 QUINCY LANE
	Group Practice or individual's line 1 address
City	WHITE PLAINS
	Group Practice or individual's city
State	NY
	Group Practice or individual's state
Zip Code	106055430
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9149469525
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y