Individual provider Active NPI

Radmila Gurkovsky, LCAT, ATR-P

  • Art Therapist
  • Staten Island, NY
National Provider Identifier
1851974174
Registry record updated Aug 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Art TherapistTaxonomy code 221700000X
License
104057-01 Issued in NY
Practice address
96 Crystal Ave
Staten Island, NY 10302-2518
Phone
(917) 535-0430
NPI assigned
May 4, 2021
Last updated
Aug 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Art Therapist 221700000X 104057-01 NY Primary

Addresses

Primary practice location

96 Crystal Ave
Staten Island, NY 10302-2518

Mailing address

96 Crystal Ave
Staten Island, NY 10302-2518
Phone (917) 535-0430

Other names 1

  • Radmila Gurkovsky Professional name

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
104057-01NYMDArt Therapist

NPI Registry JSON

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

{
    "created_epoch": "1620086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723161600000",
    "number": "1851974174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 CRYSTAL AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103022518",
            "telephone_number": "917-535-0430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 CRYSTAL AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103022518",
            "telephone_number": "917-535-0430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GURKOVSKY",
        "first_name": "RADMILA",
        "credential": "LCAT, ATR-P",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-04",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "221700000X",
            "taxonomy_group": "",
            "desc": "Art Therapist",
            "state": "NY",
            "license": "104057-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RADMILA",
            "last_name": "GURKOVSKY",
            "credential": "LCAT, ATR-P",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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 Aug 9, 2024; 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.