| Oleg Kotelskiy D.o., P.c. | |
|
3816 Nostrand Ave Brooklyn NY 11235-2013 | |
| (347) 713-6871 | |
| (347) 713-6946 |
| Full Name | Oleg Kotelskiy D.o., P.c. |
|---|---|
| Speciality | Family Medicine |
| Location | 3816 Nostrand Ave, Brooklyn, New York |
| Authorized Official Name and Position | Oleg Kotelskiy (PHYSICIAN) |
| Authorized Official Contact | 3477136871 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Oleg Kotelskiy D.o., P.c. 3816 Nostrand Ave Brooklyn NY 11235-2013 Ph: (347) 713-6871 | Oleg Kotelskiy D.o., P.c. 3816 Nostrand Ave Brooklyn NY 11235-2013 Ph: (347) 713-6871 |
| NPI Number | 1508907510 |
|---|---|
| Provider Enumeration Date | 02/11/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 4981708740 |
|---|---|
| Medicare Enrollment ID | O20070404000013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508907510 | NPI | - | NPPES |
| 2050591 | Other | NY | LICENSE NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 2050591 (New York) | Primary |
| Provider Name | Oleg M Kotelskiy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003871179 PECOS PAC ID: 2769455419 Enrollment ID: I20040819000578 |
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