SERGEY PROKHOROV (NPI# 1366419962) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366419962 |
| Entity Type | Individual |
| Full Name | SERGEY PROKHOROV |
| Credential | MD |
| Practice Address |
9817 Queens Boulevard Ll2 Rego Park NY 11374-3336 |
| Practice Telephone | 7182755600 |
| Practice Fax Number | 7182755608 |
| Mailing Telephone | 7182755600 |
| Mailing Fax Number | 7182755608 |
| Enumeration Date | 2006-03-02 |
| Last Update Date | 2011-06-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084N0402X |
Psychiatry & Neurology Specialization: Neurology with Special Qualifications in Child Neurology |
231008 | NY | Allopathic & Osteopathic Physicians |
| Street Address |
9817 QUEENS BOULEVARD LL2 |
| City | REGO PARK |
| State | NY |
| Zip Code | 11374-3336 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396754107 | Svetlana Prokhorova | Pediatrics | 9817 Queens Boulevard, Ll2, Rego Park, NY 11374-3336 | 2006-08-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134747579 | Washington Andres Sanchez | Occupational Therapist | 61 80 Woodhaven Blvd, Rego Park, NY 11374 | 2020-07-13 |
| 1285261636 | Joanna Rucinska | Home Health Aide | 6140 Wetherole Street, Rego Park, NY 11374 | 2020-03-25 |
| 1134605751 | Ella Yusupova | Specialist | 6620 Wetherole Street, Apt#2d, Rego Park, NY 11374 | 2018-07-17 |
| 1316435290 | Ilya Nektalov | Pharmacist | 9002 63rd Dr Apt 2h, Rego Park, NY 11374 | 2018-04-26 |
| 1467956623 | Celeste Lucas-powers | Social Worker | 97-37 Queens Blvd, Queens, NY 11374 | 2018-03-22 |
| 1306358114 | Mazal Katanov-nektalov | Occupational Therapist | 65-09 99th St, Apt.1t, Rego Park Queens,ny, NY 11374 | 2017-11-02 |
| 1497273866 | Alex Adrian Medina Abragan | Physical Therapist | 8616 63rd Drive, 2nd Floor, Rego Park, NY 11374 | 2017-09-06 |
| 1417472374 | Natella Yagoudaeva | Physician Assistant | 65-60 Wetherole St. Apt 4d, Rego Park, NY 11374 | 2017-08-11 |
| 1477083491 | Kei Petersen | Social Worker | Rego Park Counseling Center, 97-77 Queens Blvd., Ph Floor, Rego Park, NY 11374 | 2017-06-13 |
| 1558890988 | Irina Simidchieva | 6210 99th Street, Apt.6a, Rego Park, NY 11374 | 2017-06-08 | |
| Find all providers in zip 11374 | ||||
| Taxonomy Code | 2084N0402X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Neurology with Special Qualifications in Child Neurology |
| A Child Neurologist specializes in neurology with special skills in diagnosis and treatment of neurologic disorders of the neonatal period, infancy, early childhood, and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104132778 | Prokhorov's Pediatrics and Child Neurology PC | Psychiatry & Neurology | 9817 Queens Blvd, Ll2, Rego Park, NY 11374-3336 | 2010-08-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538665971 | Kristen Barbour | Psychiatry & Neurology | 505 E 70th St # 611, New York, NY 10021-4872 | 2018-04-04 |
| 1164940490 | Kashyar Khodabakhsh M.d.p.c. | Psychiatry & Neurology | 260 Middle Neck Rd Apt 1e, Great Neck, NY 11021-1159 | 2017-09-07 |
| 1629452685 | Inge Anita Meijer | Psychiatry & Neurology | 10 Union Sq E Fl 5, Suite 5k, New York, NY 10003-3314 | 2015-07-18 |
| 1457770620 | Rolla Nuoman | Psychiatry & Neurology | 755 N Broadway Ste 540, Sleepy Hollow, NY 10591 | 2014-04-15 |
| 1689093445 | Evelyn Olga Berman | Psychiatry & Neurology | 200 East River Rd, Rochester, NY 14623 | 2014-04-09 |
| 1760809719 | Danielle Brigham | Psychiatry & Neurology | 710 W 168th St Fl 7, New York, NY 10032-3726 | 2014-03-27 |
| 1861767931 | Pascal Saremsky | Psychiatry & Neurology | 2965 Long Beach Rd Ste 200, Oceanside, NY 11572-3255 | 2012-03-21 |
| 1316246978 | Leslie Diane Delfiner | Psychiatry & Neurology | 3415 Bainbridge Ave Fl 4, Bronx, NY 10467-2403 | 2011-03-22 |
| 1457679706 | Vijay Vishwanath | Psychiatry & Neurology | 391 Myrtle Ave Ste 1a, Albany, NY 12208-3797 | 2010-05-11 |
| 1316269707 | Elissa Yozawitz | Psychiatry & Neurology | 1410 Pelham Pkwy S Rm 316, Rose F. Kennedy Center, Bronx, NY 10461-1116 | 2010-02-25 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.