| Leonid G Zolotnitskiy Md Pc | |
|
1853 Commonwealth Ave Ste 1 Brighton MA 02135-5498 | |
| (617) 378-1344 | |
| (617) 699-0416 |
| Full Name | Leonid G Zolotnitskiy Md Pc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1853 Commonwealth Ave Ste 1, Brighton, Massachusetts |
| Authorized Official Name and Position | Anna Malysheva (CONSULTANT) |
| Authorized Official Contact | 6176500027 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Leonid G Zolotnitskiy Md Pc 100 Rosemary Way Apt 312 Needham MA 02494-1222 Ph: (617) 378-1344 | Leonid G Zolotnitskiy Md Pc 1853 Commonwealth Ave Ste 1 Brighton MA 02135-5498 Ph: (617) 378-1344 |
| NPI Number | 1013524917 |
|---|---|
| Provider Enumeration Date | 09/25/2020 |
| Last Update Date | 09/25/2020 |
| Certification Date | 09/25/2020 |
| Medicare PECOS PAC ID | 1557772241 |
|---|---|
| Medicare Enrollment ID | O20201202000467 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013524917 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Leonid Grigorievich Zolotnitskiy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528174398 PECOS PAC ID: 5092779876 Enrollment ID: I20061109000231 |
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