| Kalon Dermatology | |
|
2792 Ocean Ave Fl 2 Brooklyn NY 11229-4731 | |
| (917) 855-0007 | |
| Not Available |
| Full Name | Kalon Dermatology |
|---|---|
| Speciality | Clinic/Center |
| Location | 2792 Ocean Ave Fl 2, Brooklyn, New York |
| Authorized Official Name and Position | Joseph Iwanicki (PRACTICE OWNER) |
| Authorized Official Contact | 9178550007 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kalon Dermatology 2792 Ocean Ave Fl 2 Brooklyn NY 11229-4731 | Kalon Dermatology 2792 Ocean Ave Fl 2 Brooklyn NY 11229-4731 Ph: (917) 855-0007 |
| NPI Number | 1366035248 |
|---|---|
| Provider Enumeration Date | 02/11/2021 |
| Last Update Date | 06/15/2021 |
| Certification Date | 06/15/2021 |
| Medicare PECOS PAC ID | 0749680395 |
|---|---|
| Medicare Enrollment ID | O20210618000064 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366035248 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Primary |
| Provider Name | Michael J Gladstein |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1104848811 PECOS PAC ID: 4486637022 Enrollment ID: I20040612000370 |
| Provider Name | Jane Levitt |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1649412180 PECOS PAC ID: 2860543170 Enrollment ID: I20090626000319 |
| Provider Name | David E Biro |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1265439129 PECOS PAC ID: 5193970408 Enrollment ID: I20130312000244 |
| Provider Name | Joseph Iwanicki |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1225105513 PECOS PAC ID: 8123273455 Enrollment ID: I20130430000181 |
| Provider Name | Rita Tsipen |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1740727858 PECOS PAC ID: 6709158165 Enrollment ID: I20170818002051 |
| Provider Name | Shannen Y. Liu |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1194181982 PECOS PAC ID: 6406187632 Enrollment ID: I20191018001773 |
| Provider Name | Yelena Terushkin |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1922564186 PECOS PAC ID: 5395150999 Enrollment ID: I20210211003400 |
| Provider Name | Danny Bronshtein |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417489188 PECOS PAC ID: 6305247164 Enrollment ID: I20210630002552 |
| Provider Name | Tatiana Davydova |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1316644677 PECOS PAC ID: 7012372980 Enrollment ID: I20230427002282 |
| Provider Name | Yuliya Panina |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205553393 PECOS PAC ID: 7214478494 Enrollment ID: I20240916003521 |
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