Ivan Mikolaenko
Neurologist Vascular Neurology
100 Merrick Road Suite 128
Rockville Centre
, New York 11570-0001
Ivan Mikolaenko
Neurologist Vascular Neurology
100 Merrick Road Suite 128
Rockville Centre
, New York 11570-0001
(516) 766-2306
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About
Features
Specialties
- Neurologist
- Vascular Neurology
Languages spoken
- English
Location
First Address
- Ivan Mikolaenko
- 100 Merrick Rd Ste 128
- Rockville Centre, NY
- Zip : 11570-4821
- Fax : (516) 766-2306
- Phone : (516) 255-9031
Second Address
- Ivan Mikolaenko
- 100 Merrick Road Suite 128
- Rockville Centre, NY
- Zip : 11570-0001
- Fax : (516) 766-2306
- Phone : (516) 255-9031
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2084N0400X | Neurologist | 0109542061 | VA |
| N | 2084N0400X | Neurologist | 0116020711 | VA |
| N | 2084V0102X | Vascular Neurology | 0116020711 | VA |
National Provider Identifier
| NPI | 1023231883 |
|---|---|
| Provider Name | Ivan Mikolaenko |
| First Address | Rockville Centre, NY 11570-4821 |
| Second Address | Rockville Centre, NY 11570-0001 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 10/04/2007 |
| Last Update Date | 05/04/2012 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 1023231883 | (05) | VA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.