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NPI Code Detail

MEDICARE: MR. ROSTISLAV KRASNOV D.D.S.

MEDICARE: MR. ROSTISLAV KRASNOV D.D.S.
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
1122300000XDentist046043NY
21223G0001XGeneral Practice Dentistry008698CT
3122300000XDentistDS038562PA
4122300000XDentist27827TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1942267935
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ROSTISLAV KRASNOV D.D.S.
Provider Business Mailing Address
First Line : 330 W 42ND ST
Second Line :
City : NEW YORK
State : NY
Zip : 10036-6902
Country : US
Telephone Number : 212-631-0222
Fax Number :
Provider Business Practice Location Address
First Line : 330 W 42ND ST
Second Line :
City : NEW YORK
State : NY
Zip : 10036-6902
Country : US
Telephone Number : 212-631-0222
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/26/2006
Last Update Date : 12/31/2015

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