Individual provider Active NPI

Alexander Romanov, D.V.M.

  • Veterinarian
  • New York, NY
National Provider Identifier
1841432911
Registry record updated Jul 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
VeterinarianTaxonomy code 174M00000X
License
010783-1 Issued in NY
Practice address
650 W 168TH St # Bb1810
New York, NY 10032-3702
Phone
(917) 584-4898
NPI assigned
Apr 3, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Veterinarian 174M00000X 29VI00471400 NJ
Veterinarian 174M00000X 010783-1 NY Primary

Addresses

Primary practice location

650 W 168TH St # Bb1810
New York, NY 10032-3702

Mailing address

650 W 168TH St # Bb1810
New York, NY 10032-3702
Phone (917) 584-4898

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

LicenseStateTypeSpecialty
29VI00471400NJMDVeterinarian
010783-1NYMDVeterinarian

NPI Registry JSON

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

{
    "created_epoch": "1238716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406592000000",
    "number": "1841432911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 W 168TH ST # BB1810",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323702",
            "telephone_number": "917-584-4898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 W 168TH ST # BB1810",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100323702",
            "telephone_number": "917-584-4898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROMANOV",
        "first_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "D.V.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-04-03",
        "last_updated": "2014-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174M00000X",
            "taxonomy_group": "",
            "desc": "Veterinarian",
            "state": "NJ",
            "license": "29VI00471400",
            "primary": false
        },
        {
            "code": "174M00000X",
            "taxonomy_group": "",
            "desc": "Veterinarian",
            "state": "NY",
            "license": "010783-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2014; 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.