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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207N00000X | Dermatology | MD432473 | PA | Allopathic & Osteopathic Physicians |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1396186201 | Oleg Antonov Md PC | Specialist | 11400 Bustleton Ave, Philadelphia, PA 19116 | 2013-07-09 |
Street Address |
11400 BUSTLETON AVE |
City | PHILADELPHIA |
State | PA |
Zip Code | 19116-2815 |
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 |
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 | 207N00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Dermatology |
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. |
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 |
City | PHILADELPHIA |
Zip Code | 19116 |
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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.