Active NPI
Dmitriy Bakhramov Sr.
- Durable Medical Equipment & Medical Supplies
- Floral Park, NY
National Provider Identifier
1366101693
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- License
- 2098686
- Practice address
- 110 Jericho Tpke Ste B4
Floral Park, NY 11001-2019 - Phone
- (917) 412-7370
- NPI assigned
- Dec 14, 2021
- 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 |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | 2098686 | NY | Primary |
Addresses
Primary practice location
110 Jericho Tpke Ste B4
Floral Park, NY 11001-2019
Mailing address
110 Jericho Tpke Ste B4
Floral Park, NY 11001-2019
Phone (917) 412-7370
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2098686-DCA | Other | NY | SUPPLY |
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 |
|---|---|---|---|
| 2098686 | NY | MD | Durable Medical Equipment & Medical Supplies |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1639440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1639440000000",
"number": "1366101693",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 JERICHO TPKE STE B4",
"city": "FLORAL PARK",
"state": "NY",
"postal_code": "110012019",
"telephone_number": "917-412-7370"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 JERICHO TPKE STE B4",
"city": "FLORAL PARK",
"state": "NY",
"postal_code": "110012019",
"telephone_number": "917-412-7370"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAKHRAMOV",
"first_name": "DMITRIY",
"name_suffix": "Sr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-12-14",
"last_updated": "2021-12-14",
"certification_date": "2021-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "NY",
"license": "2098686",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SUPPLY",
"identifier": "2098686-DCA",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Floral Park, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.