VYACHESLAV DAVYDOV (NPI# 1356950497) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356950497 |
| Entity Type | Individual |
| Full Name | VYACHESLAV DAVYDOV |
| Credential | PA-C |
| Practice Address |
7901 Broadway Elmhurst NY 11373-1329 |
| Practice Telephone | 7183344000 |
| Mailing Telephone | 7183342343 |
| Mailing Fax Number | 7183345006 |
| Enumeration Date | 2020-07-24 |
| Last Update Date | 2020-08-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 025364 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
7901 BROADWAY |
| City | ELMHURST |
| State | NY |
| Zip Code | 11373-1329 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912903006 | Sambasiva Kamineni | Surgery | 7901 Broadway, Elmhurst, NY 11373-1329 | 2005-06-22 |
| 1336748433 | Lina Maria Rodriguez | Social Worker | 7901 Broadway, Elmhurst, NY 11373-1329 | 2020-10-20 |
| 1366049694 | Reinelda Glizel Diaz | Physical Therapist | 7901 Broadway, Elmhurst, NY 11373-1329 | 2020-10-09 |
| 1831796705 | Keysha Latanya Bonheur | Registered Nurse | 7901 Broadway, Elmhurst, NY 11373-1329 | 2020-10-05 |
| 1053927657 | Puja Rai | Occupational Therapist | 7901 Broadway, Elmhurst, NY 11373-1329 | 2020-09-18 |
| 1619582764 | Tenzin Wangmo | Nurse Practitioner | 7901 Broadway, Elmhurst, NY 11373-1329 | 2020-09-14 |
| 1629683578 | Carmen Maria Chavez Fuenmayor | Student in an Organized Health Care Education/Training Program | 7901 Broadway, Elmhurst, NY 11373-1329 | 2020-09-08 |
| 1093329179 | Dharma Dilia Herrera Vasquez | Student in an Organized Health Care Education/Training Program | 7901 Broadway, Elmhurst, NY 11373-1329 | 2020-09-04 |
| 1366054975 | Mackenzie Jameson | Social Worker | 7901 Broadway, Elmhurst, NY 11373-1329 | 2020-08-17 |
| 1639788201 | Nina Mariana Magdalena Andrias-ng | Registered Nurse | 7901 Broadway, Elmhurst, NY 11373-1329 | 2020-07-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376152736 | Carlos Eduardo Hallo Carrasco | Student in an Organized Health Care Education/Training Program | 79-01 Broadway, 10, C 10-19a, Elmhurst, NY 11373 | 2020-07-30 |
| 1912524034 | Jurian Feygen Kaunang | Student in an Organized Health Care Education/Training Program | Bronx-lebanon Hospital Center, 1650 Grand Concourse, Bronx, NY 11373 | 2020-07-06 |
| 1407471352 | Shreeya Parajull | Student in an Organized Health Care Education/Training Program | 79-01 Broadway Elmhurst Hospital Center:, Room A7-34, Elmhurst, NY 11373 | 2020-06-16 |
| 1114542479 | Mahmud Omar Elfituri | Student in an Organized Health Care Education/Training Program | 79-01 Boradway, Elmhurst, NY 11373 | 2020-06-12 |
| 1568091452 | Nudjarin Unsin | Licensed Practical Nurse | 7517 41stave, Apt.f3, Elmhurst, NY 11373 | 2020-04-03 |
| 1154969053 | Joshua Reyes | Physician Assistant | 8839 Saint James Ave, Elmhurst, NY 11373 | 2019-12-11 |
| 1821647926 | Shahorin Monzoor | Student in an Organized Health Care Education/Training Program | 81 14 Queens Boulavard, 1st Floor, Elmhurst, NY 11373 | 2019-09-11 |
| 1174184600 | Zoila Josefina Cano Rodriguez | Student in an Organized Health Care Education/Training Program | 7802 41st Ave, Elmhurst, NY 11373 | 2019-06-25 |
| 1891355756 | Kanghee Cho | Registered Nurse | 4143 77th St Elmhurst, Elmhurst, NY 11373 | 2019-06-13 |
| 1861971947 | Allen G Luke | Acupuncturist | 86-21 53 Ave, Elmhurst, NY 11373 | 2018-08-09 |
| Find all providers in zip 11373 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013552595 | Kendall Kilander | Physician Assistant | 133 E Brush Hill Rd Ste 310, Elmhurst, IL 60126-5662 | 2019-11-08 |
| 1962064709 | Kelly Farell | Physician Assistant | 103 N Haven Rd Ste 7, Elmhurst, IL 60126-2973 | 2019-07-02 |
| 1912470360 | Fauzia Bagum | Physician Assistant | 4036 Aske St Fl 3, Elmhurst, NY 11373-1748 | 2019-01-08 |
| 1407326382 | Meredith Brackett | Physician Assistant | 333 E Webster Ave, Elmhurst, IL 60126-3636 | 2018-12-04 |
| 1952871519 | Reda Benani | Physician Assistant | 7426 Woodside Ave, Apt 3r, Elmhurst, NY 11373-1137 | 2018-11-27 |
| 1801395082 | Shreya Amin | Physician Assistant | 8337 Saint James Ave Apt 5a, Elmhurst, NY 11373-3771 | 2018-02-02 |
| 1366974891 | Ulyana Nepokulchytska | Physician Assistant | 386 N York St Ste 100, Elmhurst, IL 60126-2365 | 2017-04-03 |
| 1285185520 | Alexandra Gold | Physician Assistant | 9424 58th Ave, Elmhurst, NY 11373-5149 | 2016-10-21 |
| 1750651980 | Imran Shahzad | Physician Assistant | 4255 80th St Apt 3g, Elmhurst, NY 11373-3041 | 2012-01-04 |
| 1538478417 | Mariah Esposito | Physician Assistant | 79-01 Broadway Elmhurst Hospital, Department of Radiology E1-85, Elmhurst, NY 11373 | 2010-09-27 |
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| 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.