MEDICARE: ADAPTATION MEDICAL, 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	207R00000X	Internal Medicine Physician	215829	NY
2	174400000X	Specialist	220248	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	:	1245367416
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADAPTATION MEDICAL, PC

Provider Business Mailing Address
First Line	:	20701 ESTATES DR
Second Line	:	3RD FLOOR
City	:	BAYSIDE
State	:	NY
Zip	:	11360-1180
Country	:	US
Telephone Number	:	718-714-6995
Fax Number	:	718-714-9346

Provider Business Practice Location Address
First Line	:	3007 OCEAN PKWY
Second Line	:	GROUND FLOOR
City	:	BROOKLYN
State	:	NY
Zip	:	11235-8302
Country	:	US
Telephone Number	:	718-714-6995
Fax Number	:	718-714-9346

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. VLADIMIR ONEFATER
Credential	:	M.D.
Telephone Number	:	718-714-6995

Provider Enumeration Date	:	02/27/2007
Last Update Date	:	10/16/2012

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