DMITRY KOTLYAR RN NPI 1710551528

NPI Information

NPI: 1710551528
Provider Name: DMITRY KOTLYAR, RN
Classification: Registered Nurse - 163WP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

Address:
777 SEAVIEW AVE
STATEN ISLAND, NY
ZIP 10305
Phone: (718) 667-2499
Get Directions

Dmitry Kotlyar, RN is a psychiatric/mental health registered nurse in Staten Island, NY. Dmitry Kotlyar, RN NPI is 1710551528. 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:

777 SEAVIEW AVE
STATEN ISLAND, NY
ZIP 10305-409
Phone: (718) 667-2499

The enumeration date for this NPI number is 5/17/2021 and was last updated on 5/17/2021.

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
1	163WP0808X	Registered Nurse	Psychiatric/Mental Health	494209	NEW YORK	Yes

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
1	2997157	MEDICAID	NEW 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: 5/5/2024

NPI Synchronization or Removal

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