Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 258729 | NY |
NPI | 1043486285 |
---|---|
Provider Name | Dmitry V Shmerkovich |
First Address | Brooklyn, NY 11235-2028 |
Second Address | Brooklyn, NY 11235-2028 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2008 |
Last Update Date | 31/07/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
FS2454825 | DEA (01) | NY |