DR. SERGEY MIRAKOV (NPI# 1629347182) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629347182 |
| Entity Type | Individual |
| Full Name | DR. SERGEY MIRAKOV |
| Credential | M.D. |
| Practice Address |
1400 Blackhorse Hill Road Bldg 39, Roomb06g Coatesville PA 19320 |
| Practice Telephone | (610) 384-7711 |
| Mailing Telephone | (610) 384-7711 |
| Enumeration Date | 2011-12-29 |
| Last Update Date | 2020-03-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
MD460854 | PA | Allopathic & Osteopathic Physicians |
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
10276247-1205 | UT | Allopathic & Osteopathic Physicians |
| N | 2084P0802X |
Psychiatry & Neurology Specialization: Addiction Psychiatry |
MD460854 | PA | Allopathic & Osteopathic Physicians |
| Y | 2084P0802X |
Psychiatry & Neurology Specialization: Addiction Psychiatry |
ME138827 | FL | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | MT204799 | PA | Student, Health Care |
| Street Address |
1400 BLACKHORSE HILL ROAD BLDG 39, ROOMB06G |
| City | COATESVILLE |
| State | PA |
| Zip Code | 19320 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235236753 | Okema Denise Scott-thomas | Social Worker | 1400 Blackhorse Hill Road, Coatesville, PA 19320 | 2006-09-19 |
| 1679046031 | Diana Marie Zinnie | Social Worker | 1400 Blackhorse Hill Road, Coatesville, PA 19320 | 2019-01-09 |
| 1205231370 | Katherine Trexler | Pharmacist | 1400 Blackhorse Hill Road, Coatesville, PA 19320 | 2014-10-30 |
| 1871826602 | Lori L. Heun | Speech-Language Pathologist | 1400 Blackhorse Hill Road, Coatesville, PA 19320-2096 | 2009-09-11 |
| 1871738088 | Margaret Cortlessa | Licensed Practical Nurse | 1400 Blackhorse Hill Road, Coatesville, PA 19363 | 2008-12-03 |
| 1013017409 | D. Mark Gillespie | Pharmacist | 1400 Blackhorse Hill Road, Coatesville, PA 19320 | 2006-09-25 |
| 1043319403 | William Allan Best Sr. | Pharmacist | 1400 Blackhorse Hill Road, Pharmacy Service (119), Coatesville, PA 19320 | 2006-09-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962029306 | Ara Dadivanyan | Psychiatry & Neurology | 201 Reeceville Rd., Brandywine Hospital, Coatesville, PA 19320 | 2020-07-01 |
| 1669098919 | Sara Mostafa | Psychiatry & Neurology | Brandy Wine Hospital, 201 Reeceville Rd, Coatesville, PA 19320 | 2020-06-23 |
| 1225654072 | Laurie Bond | Counselor | 774 East Lincoln Highway, Coatesville, PA 19320 | 2020-06-17 |
| 1356964506 | Timothy Robert Derosa | Psychiatry & Neurology | Brandywine Hospital 201 Reeceville Rd., Coatesville, Pa, PA 19320 | 2020-05-22 |
| 1184264632 | Evolve Individual Services, LLC | Counselor | 135 E Chestnut St, 204, Coatesville, PA 19320 | 2020-01-13 |
| 1649824111 | Angela Lynne Sylvina | Social Worker | 1825 E Lincoln Highway, Coatesville, PA 19320 | 2019-08-01 |
| 1629540257 | Rhonda Jean Sanford | Social Worker | Coatesville Vamc, Attn: Rhonda Sanford, Lcsw, 1400 Blackhorse Hill Rd, Bldg 57, Rm 227, Coatesvillle, PA 19320 | 2018-12-20 |
| 1528540499 | Jetquatta Parker | Licensed Practical Nurse | 786 Coates St, Coatesville, PA 19320 | 2018-09-06 |
| 1639608052 | Shafkat Hussain | Pharmacist | 800 East Lincoln Highway, Coatesville, PA 19320 | 2017-06-08 |
| 1790222032 | Elizabeth Barnett | Counselor | 2034crest Dr, Coatesville, PA 19320 | 2017-01-25 |
| Find all providers in zip 19320 | ||||
| Taxonomy Code | 2084P0802X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Addiction Psychiatry |
| Addiction Psychiatry is a subspecialty of psychiatry that focuses on evaluation and treatment of individuals with alcohol, drug, or other substance-related disorders, and of individuals with dual diagnosis of substance-related and other psychiatric disorders. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477113637 | Blue Mountain Wellness, Pllc | Psychiatry & Neurology | 415 W Main St Ste 105, Lansdale, PA 19446-2062 | 2019-06-19 |
| 1497983563 | Alla Fine | Psychiatry & Neurology | 6404 Roosevelt Blvd Ste 1c, Philadelphia, PA 19149-2943 | 2009-06-29 |
| 1952546780 | Herbert J. Steinberg | Psychiatry & Neurology | 1000 Hemlock Farms, Lords Valley, PA 18428-9066 | 2008-12-08 |
| 1639329840 | Altaf Suleman Kasmani | Psychiatry & Neurology | 226 N 6th St, Reading, PA 19601-3308 | 2008-09-24 |
| 1386650463 | Alexandra B Mclean | Psychiatry & Neurology | 150 Stafford Avenue - Bldg. 1 - 2nd Floor, Suite 210, Wayne, PA 19087-3114 | 2006-07-31 |
| 1437198363 | John J Worthington Md | Psychiatry & Neurology | 1000 York Rd, Willow Grove, PA 19090-1318 | 2006-06-06 |
| 1205832201 | Henry R Kranzler | Psychiatry & Neurology | 3900 Chestnut St, Philadelphia, PA 19104-3120 | 2005-06-23 |
| 1124631767 | The Art of Wellness Md | Psychiatry & Neurology | 610 Walnut St, Philadelphia, PA 19106 | 2020-08-24 |
| 1427438571 | Rayek Nafiz | Psychiatry & Neurology | 3910 N Powelton Ave, Philadelphia, PA 19104-2640 | 2015-06-04 |
| 1518383587 | Jaakko Lappalainen | Psychiatry & Neurology | 3900 Woodland Ave, Va/mirecc, Philadelphia, PA 19104-4551 | 2014-03-13 |
| Find all providers with the same taxonomy | ||||
| City | COATESVILLE |
| Zip Code | 19320 |
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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.