Active NPI
Tarkhanov Medical P.C.
- Primary Care Clinic/Center
- Staten Island, NY
National Provider Identifier
1508308743
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Clinic/Center
- License
- 243184
- Legal business name
- TARKHANOV MEDICAL P.C.
- Practice address
- 15 Rome Ave
Staten Island, NY 10304-4317 - Phone
- (718) 351-6203
- Fax
- (917) 652-0951
- NPI assigned
- Nov 4, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Nikolay Tarkhanov, M.D.
- Title
- Owner
- Phone
- (718) 351-6203
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Clinic/Center | 261QP2300X | 243184 | NY | Primary |
Addresses
Primary practice location
15 Rome Ave
Staten Island, NY 10304-4317
Mailing address
15 Rome Ave
Staten Island, NY 10304-4317
Phone (917) 273-9926
National Provider Directory
National Provider DirectoryLocations
5905 Strickland Ave
Brooklyn, NY 11234
Phone (718) 444-2600
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Critical Care Medicine (Internal Medicine) Physician
- Staten Island, NY
- NPI 1861476715
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1478217600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1478217600000",
"number": "1508308743",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 ROME AVE",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103044317",
"telephone_number": "917-273-9926",
"fax_number": "917-652-0951"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15 ROME AVE",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103044317",
"telephone_number": "718-351-6203",
"fax_number": "917-652-0951"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "TARKHANOV MEDICAL P.C.",
"organizational_subpart": "NO",
"enumeration_date": "2016-11-04",
"last_updated": "2016-11-04",
"status": "A",
"authorized_official_last_name": "TARKHANOV",
"authorized_official_first_name": "NIKOLAY",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "718-351-6203",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "261QP2300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Primary Care",
"state": "NY",
"license": "243184",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Staten Island, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.