OLEG ANTONOV MD PC (NPI# 1396186201) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396186201 |
| Entity Type | Organization |
| Organization Name | OLEG ANTONOV MD PC |
| Other Organization Name | 11400 BUSTLETON AVENUE |
| Practice Address |
11400 Bustleton Ave Philadelphia PA 19116 |
| Mailing Address |
11400 Bustleton Ave Philadelphia PA 19116-2815 |
| Practice Telephone | 2151111111 |
| Mailing Telephone | 2151111111 |
| Enumeration Date | 2013-07-09 |
| Last Update Date | 2013-07-09 |
| Authorized Official Name | MR. OLEG ANTONOV (OWNER) |
| Authorized Official Telephone | 2151111111 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| Other Name | Type Code |
|---|---|
| 11400 Bustleton Avenue | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710307087 | Oleg Antonov Md PC | Dermatology | 11400 Bustleton Ave, Philadelphia, PA 19116-2815 | 2014-04-24 |
| Street Address |
11400 BUSTLETON AVE |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19116 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275571945 | Oleg Volchonok | Internal Medicine | 11400 Bustleton Ave, Philadelphia, PA 19116-2815 | 2006-06-03 |
| 1710307087 | Oleg Antonov Md PC | Dermatology | 11400 Bustleton Ave, Philadelphia, PA 19116-2815 | 2014-04-24 |
| 1780962795 | Rds Rehabilitation Associates, P.C. | Specialist | 11400 Bustleton Ave, Philadelphia, PA 19116-2815 | 2011-07-25 |
| 1790951390 | Oleg Volchonok, Md, PC | Internal Medicine | 11400 Bustleton Ave, Philadelphia, PA 19116-2815 | 2008-05-02 |
| 1841481561 | Oleg Antonov | Family Medicine | 11400 Bustleton Ave, Philadelphia, PA 19116-2815 | 2007-08-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194334466 | Ambassador Home Care Services LLC | Homemaker | 118080 Bustleton Av, Suite 301, Philadelphia, PA 19116 | 2020-07-23 |
| 1669919445 | Lenore Pierce Bailey | Social Worker | 15100 Dahlia Drive, Philadelphia, PA 19116 | 2017-01-31 |
| 1477938991 | Jessica Gabriela Dashevsky | Counselor | 467 Parlin St, Philadelphia, PA 19116 | 2015-07-27 |
| 1174949697 | Absolute Therapy Care LLC | Physical Therapist | 10125 Verree Rd Ste 100, Philadelphia, PA 19116 | 2014-03-07 |
| 1790107936 | Philmont Homecare, LLC | Home Health | 14500 Bustleton Avenue, Suite 208, Philadelphia, PA 19116 | 2014-01-07 |
| 1417381609 | Able Ambulance Inc. | Ambulance | 1017 Haldeman Ave., Philadelphia, PA 19116 | 2013-08-25 |
| 1821356718 | Timur Kakhramanov | Nurse Practitioner | 301 W.byberry Rd, Unit F-6, Philadelphia, PA 19116 | 2012-04-27 |
| 1982975173 | Simon Perelshteyn | Internal Medicine | 10172 Verree Rd, Philadelphia, PA 19116 | 2012-01-19 |
| 1841574449 | Irene Feldman | Pharmacist | 10000 Busteloton Ave, Philadelphia, PA 19116 | 2011-10-03 |
| 1992095590 | Long Life Ambulance, LLC | Ambulance | 10065 Sandmeyer Lane, 103, Philadelphia, PA 19116 | 2011-04-15 |
| Find all providers in zip 19116 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174156012 | Sade Yolanda Davis | Specialist | 2414 N Garnet St, Philadelphia, PA 19132-3725 | 2020-02-19 |
| 1356803993 | Larkerra Goodson | Specialist | 1336 Arrott St Apt E15, Philadelphia, PA 19124-3281 | 2019-04-03 |
| 1306302617 | Keisha Robinson | Specialist | 6852 Regent St, Philadelphia, PA 19142-1213 | 2019-02-12 |
| 1740758168 | William Whitaker | Specialist | 1115 E Sanger St, Philadelphia, PA 19124-1130 | 2018-11-02 |
| 1902395536 | Ran Barzilay | Specialist | 3440 Market St, Suite 200, Philadelphia, PA 19104 | 2018-05-09 |
| 1093229668 | Danielle M Marshall | Specialist | 514 Seville St Apt 7, Philadelphia, PA 19128-2737 | 2017-11-19 |
| 1336651017 | Radhia Afif | Specialist | 5943 Weymouth St, Philadelphia, PA 19120-1122 | 2017-11-02 |
| 1306383401 | Helping Hair LLC | Specialist | 930 N 50th St, Philadelphia, PA 19131-5102 | 2017-01-26 |
| 1447796172 | Kristen Halvorson | Specialist | 3411 Cresson St, Apartment 6, Philadelphia, PA 19129-1654 | 2017-01-19 |
| 1174079131 | Sadia Randolph | Specialist | 6718 Paschall Ave, Philadelphia, PA 19142-1809 | 2016-08-30 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19116 |
Please comment or provide details below to improve the information on OLEG ANTONOV MD PC.
| 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.