Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 60662744 | WA |
N | 208D00000X | General Practice Physician | 153212 | FL |
N | 208D00000X | General Practice Physician | 312814 | NY |
NPI | 1376097238 |
---|---|
Provider Name | Anatoly Mitrokhin |
First Address | Brooklyn, NY 11203 |
Second Address | Brooklyn, NY 11203 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2016 |
Last Update Date | 07/10/2021 |