| Prominis Medical Services Pc | |
|
332 Dekalb Ave Brooklyn NY 11205-3820 | |
| (718) 852-5252 | |
| (718) 802-1113 |
| Full Name | Prominis Medical Services Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 332 Dekalb Ave, Brooklyn, New York |
| Authorized Official Name and Position | Andras Fenyves (OWNER) |
| Authorized Official Contact | 7188525252 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prominis Medical Services Pc 381 5th St Brooklyn NY 11215-2806 Ph: (718) 852-5252 | Prominis Medical Services Pc 332 Dekalb Ave Brooklyn NY 11205-3820 Ph: (718) 852-5252 |
| NPI Number | 1841323771 |
|---|---|
| Provider Enumeration Date | 03/13/2007 |
| Last Update Date | 02/20/2008 |
| Medicare PECOS PAC ID | 9537124441 |
|---|---|
| Medicare Enrollment ID | O20041119000601 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841323771 | NPI | - | NPPES |
| 02617105 | Medicaid | NY | |
| DD0279 | Other | NY | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 232171 (New York) | Primary |
| Provider Name | Andras Fenyves |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952467318 PECOS PAC ID: 3173436102 Enrollment ID: I20031106000531 |
| Provider Name | Richard Link |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730114547 PECOS PAC ID: 7214833599 Enrollment ID: I20031209000087 |
| Provider Name | Vladimir Volokh |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1598731564 PECOS PAC ID: 9638168099 Enrollment ID: I20040510001680 |
| Provider Name | Valeriy A Matatov |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699722736 PECOS PAC ID: 2668463928 Enrollment ID: I20040524001202 |
| Provider Name | Mark Castaldi |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1447275185 PECOS PAC ID: 6103888755 Enrollment ID: I20041027000513 |
| Provider Name | Anahid Nisanian |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942386735 PECOS PAC ID: 6406818889 Enrollment ID: I20041028000367 |
| Provider Name | Rossana Dilmanian |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821174632 PECOS PAC ID: 4183653397 Enrollment ID: I20050808001276 |
| Provider Name | Barry Dublin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649332818 PECOS PAC ID: 2769417369 Enrollment ID: I20051003000516 |
| Provider Name | Johnny Thomas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619906047 PECOS PAC ID: 8820018492 Enrollment ID: I20051128000570 |
| Provider Name | Roberto Robinson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477655017 PECOS PAC ID: 3577572189 Enrollment ID: I20060410000520 |
| Provider Name | Mark Vincent Burke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689693681 PECOS PAC ID: 3072522119 Enrollment ID: I20060418000300 |
| Provider Name | Cary S Pollack |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1285734855 PECOS PAC ID: 6204919012 Enrollment ID: I20080215000534 |
| Provider Name | Joseph Abboud |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1710168901 PECOS PAC ID: 8022195791 Enrollment ID: I20080404000369 |
| Provider Name | Eric Dessner |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1861686545 PECOS PAC ID: 4486740693 Enrollment ID: I20081208000630 |
| Provider Name | Rod Saclolo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396809091 PECOS PAC ID: 7810013711 Enrollment ID: I20100929000026 |
| Provider Name | Clark R Lopez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619016011 PECOS PAC ID: 3577559111 Enrollment ID: I20101011001127 |
| Provider Name | Dionisio B Mauro |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1972688018 PECOS PAC ID: 8123203627 Enrollment ID: I20110427000335 |
| Provider Name | Jacques C Antoine |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861569030 PECOS PAC ID: 2668621525 Enrollment ID: I20121029000054 |
| Provider Name | Valentina Boguslavskaya |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770838583 PECOS PAC ID: 3072752641 Enrollment ID: I20130612000410 |
| Provider Name | Issa Elia Jaradeh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184955270 PECOS PAC ID: 0547493876 Enrollment ID: I20140512001075 |
| Provider Name | Israel Willis |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1932448701 PECOS PAC ID: 4789829839 Enrollment ID: I20150506000335 |
| Provider Name | Lora Y Slabodkina |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881646149 PECOS PAC ID: 7012934433 Enrollment ID: I20150709000626 |
| Provider Name | Diogenes Antipas Almonte |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1861606014 PECOS PAC ID: 6204139314 Enrollment ID: I20160125000526 |
| Provider Name | Aldo Manuel Navarro Oviedo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235487703 PECOS PAC ID: 8527342013 Enrollment ID: I20170301000241 |
| Provider Name | Colette Nelson |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1952525396 PECOS PAC ID: 1052696234 Enrollment ID: I20170330002235 |
| Provider Name | Natalia E Suchorzepka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316330590 PECOS PAC ID: 3476810771 Enrollment ID: I20171121002630 |
| Provider Name | Margarita Ukman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356685473 PECOS PAC ID: 8123069796 Enrollment ID: I20171204002394 |
| Provider Name | John Angelo Giangreco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457841892 PECOS PAC ID: 4082969639 Enrollment ID: I20180622000016 |
| Provider Name | Somechukwu O Onuoha |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598141319 PECOS PAC ID: 8820342603 Enrollment ID: I20181114000686 |
| Provider Name | Natalia Kotlik |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477020600 PECOS PAC ID: 9739423864 Enrollment ID: I20181130001040 |
| Provider Name | Alexis Griffin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205348851 PECOS PAC ID: 7810233509 Enrollment ID: I20190117001378 |
| Provider Name | Jacob Alan Levy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710351515 PECOS PAC ID: 2567704612 Enrollment ID: I20190422001151 |
| Provider Name | Valerie Yvonne Sauve |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962769331 PECOS PAC ID: 2365692993 Enrollment ID: I20190620000493 |
| Provider Name | Anna Macewan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851848709 PECOS PAC ID: 2769716356 Enrollment ID: I20190702001640 |
| Provider Name | Rafael Barcia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528009461 PECOS PAC ID: 8123038882 Enrollment ID: I20191030002962 |
| Provider Name | Brock Drapkin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508832189 PECOS PAC ID: 4082679063 Enrollment ID: I20191101000378 |
| Provider Name | Arthur Jay Brantz |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1154379287 PECOS PAC ID: 0143296400 Enrollment ID: I20200602002170 |
| Provider Name | Rachel Gordon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861771867 PECOS PAC ID: 3577981117 Enrollment ID: I20200915001196 |
| Provider Name | Larissa Jerominow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285284992 PECOS PAC ID: 5991116360 Enrollment ID: I20201117000628 |
| Provider Name | Nina M Andrias-ng |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639788201 PECOS PAC ID: 8820404353 Enrollment ID: I20210309000954 |
| Provider Name | Cale S Li |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134784762 PECOS PAC ID: 7911232467 Enrollment ID: I20210611000282 |
| Provider Name | Munther Alshalabi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1033770508 PECOS PAC ID: 9537498423 Enrollment ID: I20210927000317 |
| Provider Name | Yong Woo Pak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437738986 PECOS PAC ID: 5092103598 Enrollment ID: I20211103001258 |
| Provider Name | Ryan R Spencer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447981097 PECOS PAC ID: 7810371564 Enrollment ID: I20220830003821 |
| Provider Name | Sara Darcy Wolk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871201350 PECOS PAC ID: 0749651438 Enrollment ID: I20230117000340 |
| Provider Name | Inessa Inoyatova |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649986068 PECOS PAC ID: 5698149854 Enrollment ID: I20230330000690 |
| Provider Name | Sylwia Dziwirek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417657867 PECOS PAC ID: 3870968829 Enrollment ID: I20230405001930 |
| Provider Name | Steven O Addo-yobo |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1548553605 PECOS PAC ID: 7012367675 Enrollment ID: I20231221002912 |
| Provider Name | Sara Blitenthal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801671706 PECOS PAC ID: 2466802566 Enrollment ID: I20240102003673 |
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