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STANISLAV KULISHOV PHYSICIAN P.C. NPI 1477627370


NPI Information

NPI: 1477627370
Provider Name: STANISLAV KULISHOV PHYSICIAN P.C.
Classification: Psychiatry & Neurology - 2084N0402X
Entity Type: Organization

Specialization: Neurology with Special Qualifications in Child Neurology

Address:
1833 E 13TH ST
SUITE 1A
BROOKLYN, NY
ZIP 11229
Phone: (718) 627-3939
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STANISLAV KULISHOV PHYSICIAN P.C. is a neurology with special qualifications in child neurology psychiatry neurology in Brooklyn, NY. The provider is a Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence. STANISLAV KULISHOV PHYSICIAN P.C. NPI is 1477627370. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1833 E 13TH ST
SUITE 1A
BROOKLYN, NY
ZIP 11229-807
Phone: (718) 627-3939
Fax: (718) 627-8737

The provider's authorized official is Stanislav Kulishov .
The authorized official title is President and has the following contact phone number (718) 627-3939.

The enumeration date for this NPI number is 11/20/2006 and was last updated on 11/2/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12084N0402XPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology208948NEW YORKYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1WEZ551MEDICARE ID-TYPE UNSPECIFIEDNEW YORK
203475514MEDICAIDNEW YORK
3G66731MEDICARE UPINNEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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