MEDICARE: VADIM KUSHNERIK M.D.

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	208VP0014X	Interventional Pain Medicine Physician	217486-1	NY
2	208VP0000X	Pain Medicine Physician	217486-1	NY
3	207LP2900X	Pain Medicine (Anesthesiology) Physician	217486-1	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00154899	OTHER		RAILROAD MEDICARE

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	:	1740244771
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VADIM KUSHNERIK M.D.

Provider Business Mailing Address
First Line	:	101 INDIANA PL
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-6906
Country	:	US
Telephone Number	:	212-943-4999
Fax Number	:	212-943-4999

Provider Business Practice Location Address
First Line	:	14 WALL ST STE 6A
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10005-2106
Country	:	US
Telephone Number	:	212-943-4999
Fax Number	:	212-943-1999

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

Provider Enumeration Date	:	04/14/2006
Last Update Date	:	03/02/2026

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Directions to “ VADIM KUSHNERIK M.D.” Practice Location

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