MEDICARE: DR A ABAKIN DC PC

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
1	302F00000X	Exclusive Provider Organization	010303	NY

General Provider Information

NPI Number	:	1164587127
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR A ABAKIN DC PC

Provider Business Mailing Address
First Line	:	2151 E 22ND ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-3642
Country	:	US
Telephone Number	:	718-331-9600
Fax Number	:

Provider Business Practice Location Address
First Line	:	1849 86TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11214-3108
Country	:	US
Telephone Number	:	718-331-9600
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ANATOLIY ABAKIN
Credential	:	DC
Telephone Number	:	718-331-9600

Provider Enumeration Date	:	12/27/2006
Last Update Date	:	08/22/2020

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