David Evdokimow, M.D. LLC

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

Legal business name

DAVID EVDOKIMOW, M.D. LLC

Practice address

96 South Finley Ave.
Basking Ridge, NJ 07920

Phone

(908) 221-0482

Fax

(908) 221-0482

NPI assigned

Jun 13, 2013

Organization subpart

No

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

Authorized official

Name

David Z Evdokimow, M.D.

Title

President

Phone

(908) 221-1136

Specialties & licenses 7

Addresses

Locations

Practitioners 1

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

• Mary-Laura Klesaris, MD

  • Internal Medicine Physician
  • Brooklyn, NY
  • NPI 1477512556
  NPD (past)

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

{
    "created_epoch": "1371081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371081600000",
    "number": "1124466966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 SOUTH FINLEY AVE.",
            "city": "BASKING RIDGE",
            "state": "NJ",
            "postal_code": "07920",
            "telephone_number": "908-221-0482",
            "fax_number": "908-221-0482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 SOUTH FINLEY AVE.",
            "city": "BASKING RIDGE",
            "state": "NJ",
            "postal_code": "07920",
            "telephone_number": "908-221-0482",
            "fax_number": "908-221-0482"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID EVDOKIMOW, M.D. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-13",
        "last_updated": "2013-06-13",
        "status": "A",
        "authorized_official_last_name": "EVDOKIMOW",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "Z",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "908-221-1136",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207ND0900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Dermatopathology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0105X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Surgery of the Hand",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Pediatric Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Desiree D'Amico
• Gabriella Maria D'Amodio, MS
• Amy Lynn Dahl, MSN, APN
• Daniel W. Carey, D.D.S., P.C.
• Priyanka Dave
• Marjorie E. Davidson, M.A., C.C.C.
• De Omilia Plastic Surgery PC
• Delta Community Supports, Inc.
• Denis a. Vu, D.M.D., P.C.
• Department of Veterans Affairs, NJ Health Care System

• Plastic and Reconstructive Surgery Physician in Basking Ridge, NJ
• Providers in Basking Ridge, NJ by specialty
• Plastic and Reconstructive Surgery Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2013; 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.