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NPI Code Detail

MEDICARE: ALEXEY DMITRIYEV

MEDICARE: ALEXEY DMITRIYEV
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker080551NY
21041S0200XSchool Social Worker

General Provider Information

NPI Number : 1023186749
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXEY DMITRIYEV
Provider Business Mailing Address
First Line : 60 KNOLLS CRES APT 3J
Second Line :
City : BRONX
State : NY
Zip : 10463-6321
Country : US
Telephone Number : 646-729-7039
Fax Number :
Provider Business Practice Location Address
First Line : 860 MELROSE AVE
Second Line :
City : BRONX
State : NY
Zip : 10451-4443
Country : US
Telephone Number : 917-473-6996
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2006
Last Update Date : 10/24/2018

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1255806741 — DANIELLE JASMINE WHITE LMSW
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10451-4443
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1518435098 — DOLORES MCCULLOUGH LMSW
Practice Location Address:
860 MELROSE AVE STE 2L
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Practice Fax:
1427527696 — REBECCA DRANSFIELD
Practice Location Address:
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Practice Fax:

Directions to “ ALEXEY DMITRIYEV ” Practice Location

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