| Seagate Family Medicine Associates, Llc | |
|
2064 Cropsey Ave Apt 1g Brooklyn NY 11214-6208 | |
| (718) 975-8765 | |
| Not Available |
| Full Name | Seagate Family Medicine Associates, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 2064 Cropsey Ave Apt 1g, Brooklyn, New York |
| Authorized Official Name and Position | Edward Stolyar (PRESIDENT) |
| Authorized Official Contact | 7189758765 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Seagate Family Medicine Associates, Llc 2064 Cropsey Ave Apt 1g Brooklyn NY 11214-6208 Ph: () - | Seagate Family Medicine Associates, Llc 2064 Cropsey Ave Apt 1g Brooklyn NY 11214-6208 Ph: (718) 975-8765 |
| NPI Number | 1619089091 |
|---|---|
| Provider Enumeration Date | 08/31/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 2668471624 |
|---|---|
| Medicare Enrollment ID | O20061220000487 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619089091 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Mikhail M Shpak |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639145659 PECOS PAC ID: 3274503081 Enrollment ID: I20040729000175 |
| Provider Name | Edward Stolyar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548236417 PECOS PAC ID: 1254389638 Enrollment ID: I20050112000561 |
| Provider Name | Svetlana Pyatigorskaya |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063509081 PECOS PAC ID: 0547384067 Enrollment ID: I20101029001221 |
| Provider Name | Yana Golubitskaya |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285911818 PECOS PAC ID: 0941477053 Enrollment ID: I20120112000572 |
| Provider Name | Madeline Hernandez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427421197 PECOS PAC ID: 8729380316 Enrollment ID: I20160114000391 |
| Provider Name | Natalie Semenovski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104286756 PECOS PAC ID: 9032409487 Enrollment ID: I20160526001101 |
| Provider Name | Anna Kazakova |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386902690 PECOS PAC ID: 6507284080 Enrollment ID: I20200915002824 |
| Provider Name | Ulele Okolo Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699386896 PECOS PAC ID: 7315348539 Enrollment ID: I20210625000791 |
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