Avant-garde Psychiatric Consulting Pllc | |
56 Brighton 11th St Ste 2a Brooklyn NY 11235-5304 | |
(929) 617-8635 | |
Not Available |
Full Name | Avant-garde Psychiatric Consulting Pllc |
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Speciality | Psychiatry & Neurology |
Location | 56 Brighton 11th St, Brooklyn, New York |
Authorized Official Name and Position | Igor Kirzhner (PRESIDENT) |
Authorized Official Contact | 9178818685 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Avant-garde Psychiatric Consulting Pllc 2512 E 64th St Brooklyn NY 11234-6921 Ph: () - | Avant-garde Psychiatric Consulting Pllc 56 Brighton 11th St Ste 2a Brooklyn NY 11235-5304 Ph: (929) 617-8635 |
NPI Number | 1255849949 |
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Provider Enumeration Date | 01/16/2018 |
Last Update Date | 11/27/2023 |
Certification Date | 11/21/2023 |
Medicare PECOS PAC ID | 1456613488 |
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Medicare Enrollment ID | O20180402001830 |
Identifier | Type | State | Issuer |
---|---|---|---|
1255849949 | NPI | - | NPPES |
02618160 | Medicaid | NY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
Provider Name | Igor Kirzhner |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1942311915 PECOS PAC ID: 4284610007 Enrollment ID: I20050125000669 |
Provider Name | Gennadiy Goldvekht |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1093212086 PECOS PAC ID: 6507117041 Enrollment ID: I20180924001038 |
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