Provider Demographics
NPI:1538380183
Name:VOLOKITIN, MIKHAIL (MD, DO)
Entity type:Individual
Prefix:DR
First Name:MIKHAIL
Middle Name:
Last Name:VOLOKITIN
Suffix:
Gender:M
Credentials:MD, DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 W 97TH ST APT 1B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-6004
Mailing Address - Country:US
Mailing Address - Phone:212-665-3200
Mailing Address - Fax:212-665-4756
Practice Address - Street 1:50 W 97TH ST APT 1B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-6004
Practice Address - Country:US
Practice Address - Phone:212-665-3200
Practice Address - Fax:212-665-4756
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY205383204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01745495Medicaid
NY01745495Medicaid
NY918092Medicare ID - Type UnspecifiedPROVIDER
NY918091Medicare ID - Type UnspecifiedPROVIDER