MEDICARE: ARTEM PINKHASOV P.A.C

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	363AS0400X	Surgical Physician Assistant	0162681	NY

General Provider Information

NPI Number	:	1740527845
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARTEM PINKHASOV P.A.C

Provider Business Mailing Address
First Line	:	4232 FRANCIS LEWIS BLVD LOWR LEVEL
Second Line	:
City	:	BAYSIDE
State	:	NY
Zip	:	11361-2561
Country	:	US
Telephone Number	:	718-750-1665
Fax Number	:

Provider Business Practice Location Address
First Line	:	4232 FRANCIS LEWIS BLVD LOWR LEVEL
Second Line	:
City	:	BAYSIDE
State	:	NY
Zip	:	11361-2561
Country	:	US
Telephone Number	:	718-750-1665
Fax Number	:

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

Provider Enumeration Date	:	01/09/2013
Last Update Date	:	02/10/2025

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