Provider Type Icon

OLEG ANTONOV MD PC NPI 1710307087


NPI Information

NPI: 1710307087
Provider Name: OLEG ANTONOV MD PC
Classification: Dermatology - 207N00000X
Entity Type: Organization
Address:
11400 BUSTLETON AVE
PHILADELPHIA, PA
ZIP 19116
Phone: (267) 639-0528
Get Directions

OLEG ANTONOV MD PC is a dermatology in Philadelphia, PA. The provider is a dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. OLEG ANTONOV MD PC NPI is 1710307087. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

11400 BUSTLETON AVE
PHILADELPHIA, PA
ZIP 19116-815
Phone: (267) 639-0528
Fax: (215) 969-4451

The provider's authorized official is Oleg Antonov .
The authorized official title is Owner and has the following contact phone number (267) 639-0528.

The enumeration date for this NPI number is 4/24/2014 and was last updated on 4/24/2014.


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
1207N00000XDermatologyMD432473PENNSYLVANIAYes

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: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.