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NPI Code Detail

MEDICARE: DMITRY KAGANOVSKY

MEDICARE: DMITRY KAGANOVSKY
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1891533527
Entity Type Code : Individual
Provider Name (Legal Business Name) : DMITRY KAGANOVSKY
Provider Business Mailing Address
First Line : 2334 E 28TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11229-5034
Country : US
Telephone Number : 646-617-6828
Fax Number : 972-264-0870
Provider Business Practice Location Address
First Line : 2334 E 28TH ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11229-5034
Country : US
Telephone Number : 646-617-6828
Fax Number : 972-264-0870
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2024
Last Update Date : 07/17/2024

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Directions to “ DMITRY KAGANOVSKY ” Practice Location

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