| Stanislav Kulishov Physician P.c. | |
|
1833 E 13th St Suite 1a Brooklyn NY 11229-2807 | |
| (718) 627-3939 | |
| (718) 627-8737 |
| Full Name | Stanislav Kulishov Physician P.c. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1833 E 13th St, Brooklyn, New York |
| Authorized Official Name and Position | Stanislav Kulishov (PRESIDENT) |
| Authorized Official Contact | 7186273939 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stanislav Kulishov Physician P.c. 1833 E 13th St Suite 1a Brooklyn NY 11229-2807 Ph: (718) 627-3939 | Stanislav Kulishov Physician P.c. 1833 E 13th St Suite 1a Brooklyn NY 11229-2807 Ph: (718) 627-3939 |
| NPI Number | 1477627370 |
|---|---|
| Provider Enumeration Date | 11/20/2006 |
| Last Update Date | 11/02/2012 |
| Medicare PECOS PAC ID | 2365456704 |
|---|---|
| Medicare Enrollment ID | O20060206000506 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477627370 | NPI | - | NPPES |
| 03475514 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0402X | Psychiatry & Neurology - Neurology With Special Qualifications In Child Neurology | 208948 (New York) | Primary |
| Provider Name | Boris Spector |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1326043142 PECOS PAC ID: 4082696174 Enrollment ID: I20040602001503 |
| Provider Name | Stanislav Kulishov |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1497857502 PECOS PAC ID: 5890714646 Enrollment ID: I20051122000257 |
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