Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 170100000X | Medical Geneticist | 223328 | NY |
Y | 207Q00000X | Family Doctor | 223328 | NY |
NPI | 1376587246 |
---|---|
Provider Name | Dr. Mikhail Paikin |
First Address | Staten Island, NY 10305-4512 |
Second Address | Staten Island, NY 10305-4512 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2006 |
Last Update Date | 07/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02238017 | (05) | NY |
H60736 | (02) | NY |