Organization Active NPI

Dmitriy Yadgarov

  • Specialist
  • Rego Park, NY
National Provider Identifier
1508097767
Registry record updated Aug 5, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
234729 Issued in NY
Legal business name
DMITRIY YADGAROV
Practice address
6433 98TH St Apt 1E
Rego Park, NY 11374-3301
Phone
(718) 261-9100
Fax
(718) 897-2915
NPI assigned
Aug 5, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2009

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

Authorized official

Name
Dmitriy Yadgarov, M.D.NPI 1831395078
Title
President
Phone
(718) 261-9100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 234729 NY Primary

Addresses

Primary practice location

6433 98TH St Apt 1E
Rego Park, NY 11374-3301

Mailing address

6433 98TH St Apt 1E
Rego Park, NY 11374-3301
Phone (718) 261-9100

Other identifiers 1

IdentifierTypeStateIssuer
234729OtherNYLICENSE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1249430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249430400000",
    "number": "1508097767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6433 98TH ST APT 1E",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113743301",
            "telephone_number": "718-261-9100",
            "fax_number": "718-897-2915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6433 98TH ST APT 1E",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113743301",
            "telephone_number": "718-261-9100",
            "fax_number": "718-897-2915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DMITRIY YADGAROV",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-05",
        "last_updated": "2009-08-05",
        "status": "A",
        "authorized_official_last_name": "YADGAROV",
        "authorized_official_first_name": "DMITRIY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "718-261-9100",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "234729",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "234729",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rego Park, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2009; 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.