Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | 006017 | NY |
N | 213ES0131X | Foot Surgery | 006017 | NY |
NPI | 1245294503 |
---|---|
Provider Name | Dr. Vadim Nekritin |
First Address | Brooklyn, NY 11229-4917 |
Second Address | Brooklyn, NY 11229-4917 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2006 |
Last Update Date | 26/01/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02569611 | (05) | NY |
U99204 | (02) | NY |