MEDICARE: ANATOLY STAROSTA

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	225100000X	Physical Therapist	018716	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205896040
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANATOLY STAROSTA

Provider Business Mailing Address
First Line	:	1704 MERMAID AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11224-2622
Country	:	US
Telephone Number	:	718-265-0900
Fax Number	:

Provider Business Practice Location Address
First Line	:	1704 MERMAID AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11224-2622
Country	:	US
Telephone Number	:	718-265-0900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/24/2006
Last Update Date	:	04/09/2010

Similar Medicare Providers

1760465371 — DR. CARLOS M PEREZ MD
Practice Location Address:

1704 MERMAID AVE
BROOKLYN, NY
11224-2622

Practice Phone: 718-265-0900
Practice Fax: 718-265-6319

1053379362 — MERMAID OPERATING CO, LLC
Practice Location Address:

1704 MERMAID AVE
BROOKLYN, NY
11224-2622

Practice Phone: 718-265-0900
Practice Fax: 718-265-6319

1659478584 — BALAJI PHARMACY INC
Practice Location Address:

1708 MERMAID AVE
BROOKLYN, NY
11224-2622

Practice Phone: 718-996-9000
Practice Fax: 718-449-5106

1255654851 — MOHAN TALAMATI RPH
Practice Location Address:

1708 MERMAID AVE
BROOKLYN, NY
11224-2622

Practice Phone: 718-996-9000
Practice Fax:

1962793273 — MERMAID MANAGEMENT INC
Practice Location Address:

1704 06 MERMAID AVENUE
BROOKLYN, NY
11224-2622

Practice Phone: 718-265-0900
Practice Fax: 718-265-6319

1902436728 — CONEY ISLAND MEDICAL DIAGNOSTIC SERVICES P C
Practice Location Address:

1704 MERMAID AVE STE 6
BROOKLYN, NY
11224-2622

Practice Phone: 516-567-5410
Practice Fax:

Directions to “ ANATOLY STAROSTA ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.