MEDICARE: DR. VADIM NEKRITIN DPM

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	213EP1101X	Primary Podiatric Medicine Podiatrist	006017	NY
2	213ES0131X	Foot Surgery Podiatrist	006017	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	:	1245294503
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VADIM NEKRITIN DPM

Provider Business Mailing Address
First Line	:	2306 AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-4917
Country	:	US
Telephone Number	:	718-769-8210
Fax Number	:	718-769-8087

Provider Business Practice Location Address
First Line	:	2306 AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-4917
Country	:	US
Telephone Number	:	718-769-8210
Fax Number	:	718-769-8087

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

Provider Enumeration Date	:	04/13/2006
Last Update Date	:	01/26/2009

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