Prokhorov'S Pediatrics and Child Neurology PC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

PROKHOROV'S PEDIATRICS AND CHILD NEUROLOGY PC

Practice address

9817 Queens Blvd
LL2
Rego Park, NY 11374-3336

Phone

(718) 275-5600

Fax

(718) 275-5608

NPI assigned

Aug 20, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Svetlana Prokhorova, MDNPI 1396754107

Title

President

Phone

(718) 938-8762

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Svetlana Prokhorova, M.D.

  • Pediatrics Physician
  • Rego Park, NY
  • NPI 1396754107

  NY, Pediatrics

  Medicare reassignment NPD Authorized official
• Sergey Prokhorov, MD

  • Neurology with Special Qualifications in Child Neurology Physician
  • Rego Park, NY
  • NPI 1366419962

  Neurology With Special Qualifications in Child Neurology, NY

  Medicare reassignment NPD

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

{
    "created_epoch": "1282262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307059200000",
    "number": "1104132778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9817 QUEENS BLVD",
            "address_2": "LL2",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113743336",
            "telephone_number": "718-275-5600",
            "fax_number": "718-275-5608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9817 QUEENS BLVD",
            "address_2": "LL2",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113743336",
            "telephone_number": "718-275-5600",
            "fax_number": "718-275-5608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROKHOROV'S PEDIATRICS AND CHILD NEUROLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-20",
        "last_updated": "2011-06-03",
        "status": "A",
        "authorized_official_last_name": "PROKHOROVA",
        "authorized_official_first_name": "SVETLANA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-938-8762",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Prohealth Compounding Pharmacy Corp
• Sergey Prokhorov, MD
• Svetlana Prokhorova, M.D.
• Pronounce and Polish LLC
• Provision at New York LLC
• PT for All PC
• PT Rehabilitation PC

• All providers in Rego Park, NY
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.