OLEG ANTONOV MD PC


Address: 11400 Bustleton Ave, Philadelphia, PA 19116-2815
Phone: 2676390528

OLEG ANTONOV MD PC (NPI# 1710307087) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1710307087
Entity Type Organization
Organization Name OLEG ANTONOV MD PC
Practice Address 11400 Bustleton Ave
Philadelphia
PA 19116-2815
Practice Telephone 2676390528
Practice Fax Number 2159694451
Mailing Telephone 2676390528
Mailing Fax Number 2159694451
Enumeration Date 2014-04-24
Last Update Date 2014-04-24
Authorized Official Name DR. OLEG ANTONOV (OWNER)
Authorized Official Telephone 2676390528
Authorized Official Credential M.D.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207N00000X Dermatology MD432473 PA Allopathic & Osteopathic Physicians

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1396186201 Oleg Antonov Md PC Specialist 11400 Bustleton Ave, Philadelphia, PA 19116 2013-07-09

Office Location

Street Address 11400 BUSTLETON AVE
City PHILADELPHIA
State PA
Zip Code 19116-2815

Providers in the same location

NPI Name Taxonomy Address Enumeration
1275571945 Oleg Volchonok Internal Medicine 11400 Bustleton Ave, Philadelphia, PA 19116-2815 2006-06-03
1396186201 Oleg Antonov Md PC Specialist 11400 Bustleton Ave, Philadelphia, PA 19116 2013-07-09
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

Providers in the same zip code

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 Information

Taxonomy Code 207N00000X
Grouping Allopathic & Osteopathic Physicians
Classification Dermatology

Taxonomy Definition

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1932740461 Mark Abdelmalek, Md LLC Dermatology 200 N 16th St Ste D, Philadelphia, PA 19102-1225 2019-10-07
1083061048 Brandon Rowe Dermatology 1316 W Ontario St Fl 1, Philadelphia, PA 19140-5220 2016-05-19
1942647078 Jason Marc Schoenfeld Dermatology 9501 Roosevelt Blvd Ste 506, Philadelphia, PA 19114-1030 2013-05-30
1588890669 Philippe Lafaille Dermatology 1200 Locust Street, Philadelphia, PA 19107 2009-06-03
1194950683 Jisun Cha Dermatology 833 Chestnut St Ste 740, Philadelphia, PA 19107-4409 2009-05-27
1962546952 Susan C. Taylor Dermatology 932 Pine St, Philadelphia, PA 19107-6128 2007-02-16
1194833590 Harold Farber Dermatology 9892 Bustleton Avenue, Ste 204 Moss Plaza, Philadelphia, PA 19115 2006-08-26
1770599839 Seana Patrice Covello Dermatology 621 Pine St, Philadelphia, PA 19106-4108 2006-07-31
1528080512 Kenneth E Wasserman Md PC Dermatology 1817 South Broad St, Philadelphia, PA 19148-2115 2006-07-25
1811947351 James R Treat Dermatology 3550 Market St Fl 2, Children's Hospital of Philadelphia - Dermatology Div, Philadelphia, PA 19104-3366 2006-05-12
Find all providers in PHILADELPHIA

Competitor

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City PHILADELPHIA
Zip Code 19116

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Dataset Information

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.

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