OTAKHON MATCHANOV
Student in an Organized Health Care Education/Training Program

Address: 1 Brookdale Plz, Brooklyn, NY 11212-3139

OTAKHON MATCHANOV (NPI# 1578158333) 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) 1578158333
Entity Type Individual
Full Name DR. OTAKHON MATCHANOV
Gender Male
Credential MD
Practice Address 1 Brookdale Plz
Brooklyn
NY 11212-3139
Practice Telephone 7182406205
Mailing Address 2665 Homecrest Ave Apt 4l
Brooklyn
NY 11235-4543
Mailing Telephone 9177339948
Certification Date 2021-03-03
Enumeration Date 2021-03-03
Last Update Date 2021-03-03
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification Group License Number License State Taxonomy Group
Y 390200000X Student in an Organized Health Care Education/Training Program Student, Health Care

Office Location

Street Address 1 BROOKDALE PLZ
City BROOKLYN
State NY
Zip Code 11212-3139

Providers in the same location

NPI Name Taxonomy Address Enumeration
1710572177 Khushbu Patel Student in an Organized Health Care Education/Training Program 1 Brookdale Plz, Brooklyn, NY 11212-3139 2021-03-07
1255926952 Emad Tawadros Boshra Tawadros Student in an Organized Health Care Education/Training Program 1 Brookdale Plz, Brooklyn, NY 11212-3139 2021-03-04
1558956342 Clorene Cadet Student in an Organized Health Care Education/Training Program 1 Brookdale Plz, Brooklyn, NY 11212-3139 2021-03-04
1568057156 Richard Joseph Dicasoli Student in an Organized Health Care Education/Training Program 1 Brookdale Plz, Brooklyn, NY 11212-3139 2021-03-04
1255926275 Dmitrii Malnev Student in an Organized Health Care Education/Training Program 1 Brookdale Plz, Brooklyn, NY 11212-3139 2021-03-02
1396330403 Pei-Ting Chen Student in an Organized Health Care Education/Training Program 1 Brookdale Plz, Brooklyn, NY 11212-3139 2021-03-02
1427643477 Mohammad Zeeshan Ozair Student in an Organized Health Care Education/Training Program 1 Brookdale Plz, Brooklyn, NY 11212-3139 2021-03-02
1548855505 Alexander Barsegian Student in an Organized Health Care Education/Training Program 1 Brookdale Plz, Brooklyn, NY 11212-3139 2021-03-02
1598350530 Melissa Cruces Andrade Student in an Organized Health Care Education/Training Program 1 Brookdale Plz, Brooklyn, NY 11212-3139 2021-03-02
1639764608 Paul Ebenezer Kwaw Ankah Student in an Organized Health Care Education/Training Program 1 Brookdale Plz, Brooklyn, NY 11212-3139 2021-03-02
Find all providers in the same address

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1609334325 Jennifer M Cushman Student in an Organized Health Care Education/Training Program Brookdale University Hospital Medical Center, 1 Brookdale Plaza Brooklyn, NY 11212-3139 2019-03-12
1770057168 Ese Uwagbale Student in an Organized Health Care Education/Training Program 1 Brookdale Plaza, Internal Medicine, Brooklyn, NY 11212-3139 2019-01-18
1639513716 Scott B Keller Radiology · Vascular & Interventional Radiology 1 Brookdale Plaza, Obh Advanced Imaging, Brooklyn, NY 11212-3139 2013-04-19
1528336096 Shepard H. Splain Do PC Specialist 1 Brookdale Plaza, Brooklyn, NY 11212-3139 2011-12-12
1750691424 Aurea Illias-Rivera Social Worker · Clinical 1 Brookdale Plaza, Brooklyn, NY 11212-3139 2010-10-15
1447332614 Nicholas J Gargiulo IIi Surgery · Vascular Surgery 1 Brookdale Plaza, 2nd Floor Chc, Brooklyn, NY 11212-3139 2006-10-19

Providers in the same zip code prefix

NPI Name Taxonomy Address Enumeration
1649877226 Simranpreet Gill Student in an Organized Health Care Education/Training Program 1 Brookdale Plaza, Brooklyn, Brooklyn, NY 11212 2020-10-06
1912514688 Somaya Abdelhaim Abuelazm Student in an Organized Health Care Education/Training Program 1 Brookdale Plaza, Brooklyn, Ny 1, Brooklyn, NY 11212 2020-09-28
1669098562 Akriti Pokhrel Student in an Organized Health Care Education/Training Program One Brookdale Plaza, Brooklyn, NY 11212 2020-06-17
1831714682 Denisa Pavlickova Student in an Organized Health Care Education/Training Program Brookdale Plaza, New York, Brooklyn, NY 11212 2020-06-08
1386268571 Lok Raj Pahari Student in an Organized Health Care Education/Training Program 1 Brookdale Plaza, Brooklyn, NY 11212 2020-06-03
1396365136 Ama Asabea Asare Student in an Organized Health Care Education/Training Program Emergency Medicine, Brookdale University Hospital and M, 1 Brookdale Plaza, Brooklyn, NY 11212 2020-04-22
1811516560 Amrusha Musunuru Student in an Organized Health Care Education/Training Program Room 222 Chc, Department of Surgical Services, The Broo, Brookdale, NY 11212 2020-04-13
1023647963 Brandon Buchel Student in an Organized Health Care Education/Training Program 1 Brookdale Plaza, Department of Emergency Medicine, Brooklyn, NY 11212 2020-04-03
1174151377 Abrar Justin Ahmed Student in an Organized Health Care Education/Training Program 1 Brookdale Plaza, Emergency Medicine Residency Program, Brooklyn, NY 11212 2020-04-01
1245875335 Veronica Lomakina Pharmacist 1 Brookdale Plaza, Brooklyn, NY 11212 2019-11-12
Find all providers in zip 11212

Taxonomy Information

Taxonomy Code 390200000X
Grouping Student, Health Care
Classification Student in an Organized Health Care Education/Training Program

Taxonomy Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Notes: [1/1/2005: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1710572177 Khushbu Patel 1 Brookdale Plz, Brooklyn, NY 11212-3139 2021-03-07
1508451030 Bryant Ka Lau 760 Broadway, Brooklyn, NY 11206-5317 2021-03-05
1255926952 Emad Tawadros Boshra Tawadros 1 Brookdale Plz, Brooklyn, NY 11212-3139 2021-03-04
1558956342 Clorene Cadet 1 Brookdale Plz, Brooklyn, NY 11212-3139 2021-03-04
1568057156 Richard Joseph Dicasoli 1 Brookdale Plz, Brooklyn, NY 11212-3139 2021-03-04
1255926275 Dmitrii Malnev 1 Brookdale Plz, Brooklyn, NY 11212-3139 2021-03-02
1396330403 Pei-Ting Chen 1 Brookdale Plz, Brooklyn, NY 11212-3139 2021-03-02
1427643477 Mohammad Zeeshan Ozair 1 Brookdale Plz, Brooklyn, NY 11212-3139 2021-03-02
1548855505 Alexander Barsegian 1 Brookdale Plz, Brooklyn, NY 11212-3139 2021-03-02
1588259584 Ruddy G Rincon 514 49th St, Brooklyn, NY 11220-2010 2021-03-02
Find all providers in BROOKLYN

Competitor

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City BROOKLYN
Zip Code 11212

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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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