| Avant-garde Psychiatric Consulting Pllc | |
|
56 Brighton 11th St Ste 2a Brooklyn NY 11235-5304 | |
| (929) 617-8635 | |
| Not Available |
| Full Name | Avant-garde Psychiatric Consulting Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 56 Brighton 11th St, Brooklyn, New York |
| Authorized Official Name and Position | Igor Kirzhner (PRESIDENT) |
| Authorized Official Contact | 9178818685 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Avant-garde Psychiatric Consulting Pllc 2512 E 64th St Brooklyn NY 11234-6921 Ph: () - | Avant-garde Psychiatric Consulting Pllc 56 Brighton 11th St Ste 2a Brooklyn NY 11235-5304 Ph: (929) 617-8635 |
| NPI Number | 1255849949 |
|---|---|
| Provider Enumeration Date | 01/16/2018 |
| Last Update Date | 11/27/2023 |
| Certification Date | 11/21/2023 |
| Medicare PECOS PAC ID | 1456613488 |
|---|---|
| Medicare Enrollment ID | O20180402001830 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255849949 | NPI | - | NPPES |
| 02618160 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Igor Kirzhner |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942311915 PECOS PAC ID: 4284610007 Enrollment ID: I20050125000669 |
| Provider Name | Vilor Shpitalnik |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629094495 PECOS PAC ID: 7719919075 Enrollment ID: I20050907000899 |
| Provider Name | Vadim Y Korol |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417033812 PECOS PAC ID: 8022114230 Enrollment ID: I20070504000318 |
| Provider Name | Ianina Suponitsky |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124407465 PECOS PAC ID: 0840590121 Enrollment ID: I20170824003674 |
| Provider Name | Gennadiy Goldvekht |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093212086 PECOS PAC ID: 6507117041 Enrollment ID: I20180924001038 |
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