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586 Midland Ave Ste B Staten Island NY 10306-5903 | |
| (646) 598-7791 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Internal Medicine |
| Location | 586 Midland Ave Ste B, Staten Island, New York |
| Authorized Official Name and Position | Milena Kolesnikova (OWNER) |
| Authorized Official Contact | 9803302025 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
586 Midland Ave Ste B Staten Island NY 10306-5903 Ph: (646) 598-7791 | 586 Midland Ave Ste B Staten Island NY 10306-5903 Ph: (646) 598-7791 |
| NPI Number | 1700404720 |
|---|---|
| Provider Enumeration Date | 07/07/2020 |
| Last Update Date | 09/22/2021 |
| Medicare PECOS PAC ID | 1254748320 |
|---|---|
| Medicare Enrollment ID | O20210408000537 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700404720 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Inna Shvartsman |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1710208343 PECOS PAC ID: 0648395665 Enrollment ID: I20100915000050 |
| Provider Name | Andrey Kolesnikov |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1962661538 PECOS PAC ID: 1355592577 Enrollment ID: I20191010001889 |
| Provider Name | Milena Kolesnikova |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285065557 PECOS PAC ID: 9537381389 Enrollment ID: I20210215000428 |
| Provider Name | Albert Avany |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1700380888 PECOS PAC ID: 1951841790 Enrollment ID: I20240909000617 |
| Provider Name | Inna Abramyuk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659065407 PECOS PAC ID: 4981139763 Enrollment ID: I20241203002853 |
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