Individual provider Active NPI

Albina V Malanchuk, D.D.S

  • Prosthodontics
  • New York, NY
National Provider Identifier
1275760050
Registry record updated Jul 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
054933-1 Issued in NY
Practice address
225 Broadway
New York, NY 10007-3001
Phone
(917) 685-0309
NPI assigned
Jun 18, 2009
Last updated
Jul 13, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X 054933-1 NY Primary

Addresses

Primary practice location

225 Broadway
New York, NY 10007-3001

Mailing address

1719 Quentin Rd Apt 6E
Brooklyn, NY 11229-1219
Phone (917) 685-0309

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160511000541 NY Order and Referring Only - DentistPractitioner - Dentist 3375832553

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
054933-1NYMDProsthodontist
054933NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1245283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405209600000",
    "number": "1275760050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1719 QUENTIN RD APT 6E",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291219",
            "telephone_number": "917-685-0309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 BROADWAY",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100073001",
            "telephone_number": "917-685-0309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALANCHUK",
        "first_name": "ALBINA",
        "middle_name": "V",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-18",
        "last_updated": "2014-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "NY",
            "license": "054933-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.