Individual provider Active NPI

Vladimir Ignatius Wnuk

  • Family Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1053536433
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
129205 Issued in NY
Practice address
183 Nassau Ave
Brooklyn, NY 11222-6838
Phone
(718) 389-3622
Fax
(718) 389-3622
NPI assigned
Apr 13, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 129205 NY Primary

Addresses

Primary practice location

183 Nassau Ave
Brooklyn, NY 11222-6838

Mailing address

10 W 15TH St
New York, NY 10011-6838
Phone (212) 691-7004

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
129205NYMDFamily Medicine Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053536433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 W 15TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100116838",
            "telephone_number": "212-691-7004",
            "fax_number": "212-691-7004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "183 NASSAU AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112226838",
            "telephone_number": "718-389-3622",
            "fax_number": "718-389-3622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WNUK",
        "first_name": "VLADIMIR",
        "middle_name": "IGNATIUS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "129205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.