Active NPI
Stanislav Myaskovsky
- Pharmacotherapy Pharmacist
- Fairfax, VA
National Provider Identifier
1194076141
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacotherapy Pharmacist
- License
- 0202209347
- Practice address
- 10580 Arrowhead Drive
Fairfax Health Center
Fairfax, VA 22030 - Phone
- (571) 432-2680
- Fax
- (571) 432-2795
- NPI assigned
- Sep 29, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacotherapy Pharmacist | 1835P1200X | 0202209347 | VA | Primary |
Addresses
Primary practice location
10580 Arrowhead Drive
Fairfax Health Center
Fairfax, VA 22030
Mailing address
10580 Arrowhead Drive
Fairfax Health Center
Fairfax, VA 22030
Phone (571) 432-2680
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0202209347 | VA | MD | Pharmacotherapy Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1348876800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1362441600000",
"number": "1194076141",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10580 ARROWHEAD DRIVE",
"address_2": "FAIRFAX HEALTH CENTER",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "22030",
"telephone_number": "571-432-2680",
"fax_number": "571-432-2795"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10580 ARROWHEAD DRIVE",
"address_2": "FAIRFAX HEALTH CENTER",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "22030",
"telephone_number": "571-432-2680",
"fax_number": "571-432-2795"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MYASKOVSKY",
"first_name": "STANISLAV",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-09-29",
"last_updated": "2013-03-05",
"status": "A"
},
"taxonomies": [
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "VA",
"license": "0202209347",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairfax, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 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.