| Marat Chaikhoutdinov, Medical P.c. | |
|
1513 Voorhies Ave Second Floor Brooklyn NY 11235-3994 | |
| (718) 332-4440 | |
| (718) 332-0077 |
| Full Name | Marat Chaikhoutdinov, Medical P.c. |
|---|---|
| Speciality | Clinic/Center |
| Location | 1513 Voorhies Ave, Brooklyn, New York |
| Authorized Official Name and Position | Marat G Chaikhoutdinov (PRESIDENT) |
| Authorized Official Contact | 2094793226 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Marat Chaikhoutdinov, Medical P.c. 105 Kings Hwy Apt. 5c Brooklyn NY 11214-1525 Ph: (209) 479-3226 | Marat Chaikhoutdinov, Medical P.c. 1513 Voorhies Ave Second Floor Brooklyn NY 11235-3994 Ph: (718) 332-4440 |
| NPI Number | 1538333679 |
|---|---|
| Provider Enumeration Date | 04/18/2008 |
| Last Update Date | 09/12/2008 |
| Medicare PECOS PAC ID | 3375603806 |
|---|---|
| Medicare Enrollment ID | O20081114000003 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538333679 | NPI | - | NPPES |
| 00A877660 | Medicaid | CA | |
| I28306 | Other | NY | UPIN |
| 02823449 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 240497 (New York) | Primary |
| Provider Name | Grigory Shtender |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1952316614 PECOS PAC ID: 1850375635 Enrollment ID: I20040617001142 |
| Provider Name | Marat Chaikhoutdinov |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063590891 PECOS PAC ID: 1557301942 Enrollment ID: I20070227000260 |
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