Raskolnikov, Dima

Raskolnikov, Dima is an individual health care provider with primary practice located at 1250 Waters Pl Ph , Bronx NY 10461-2720. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Raskolnikov, Dima can be contacted via phone (718) 920-4531.

Contact Information

Primary practice address
1250 Waters Pl Ph Bronx NY 10461-2720
Phone: (718) 920-4531
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Urology 208800000X 316573 New York

Profile Details

NPI number 1790172500
LBN Legal business name Raskolnikov, Dima
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 20th, 2015
Last updated Aug 7th, 2022 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790172500 NPPES
Washington MEDICAID 1790172500

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