DR. ANDREY GONCHARUK M.D. NPI 1356349922

NPI Information

  • NPI: 1356349922
  • Provider Name: DR. ANDREY GONCHARUK, M.D.
  • Classification: Internal Medicine - 207RN0300X
  • Specialization: Nephrology
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 300 OLD COUNTRY RD
    SUITE 111
    MINEOLA, NY
    ZIP 11501
  • Phone: (516) 745-0500

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NPI Details

DR. Andrey Goncharuk, M.D. is a nephrology internal medicine in Mineola, NY. The provider is an internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. DR. Andrey Goncharuk, M.D. NPI is 1356349922. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

300 OLD COUNTRY RD
SUITE 111
MINEOLA, NY
ZIP 11501-198
Phone: (516) 745-0500
Fax: (516) 745-1534

The NPI 1356349922 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/8/2005 and was last updated on 8/9/2012.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RN0300XInternal MedicineNephrology199896NEW 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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
101888637MEDICAIDNEW YORK
222N391MEDICARE ID-TYPE UNSPECIFIEDNEW YORK
3G48791MEDICARE 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: 11/21/2025

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