| Oleg Sirotnikov, L.c.s.w.,p.c. | |
|
101 Dartmouth St Valley Stream NY 11581-3215 | |
| (917) 239-0106 | |
| (516) 295-2659 |
| Full Name | Oleg Sirotnikov, L.c.s.w.,p.c. |
|---|---|
| Speciality | Social Worker |
| Location | 101 Dartmouth St, Valley Stream, New York |
| Authorized Official Name and Position | Oleg Sirotnikov (CEO) |
| Authorized Official Contact | 9172390106 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Oleg Sirotnikov, L.c.s.w.,p.c. 101 Dartmouth St Valley Stream NY 11581-3215 Ph: (917) 239-0106 | Oleg Sirotnikov, L.c.s.w.,p.c. 101 Dartmouth St Valley Stream NY 11581-3215 Ph: (917) 239-0106 |
| NPI Number | 1427359918 |
|---|---|
| Provider Enumeration Date | 11/15/2010 |
| Last Update Date | 11/15/2010 |
| Medicare PECOS PAC ID | 7012103336 |
|---|---|
| Medicare Enrollment ID | O20101130000083 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427359918 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | P058840-1 (New York) | Primary |
| Provider Name | Oleg Sirotnikov |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578525234 PECOS PAC ID: 1355537671 Enrollment ID: I20101130000133 |
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