Doctor Name: | SERGIY KUSHCHAYEV |
NPI Number: | 1669810271 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD PHD |
License Number: | |
Business Practice Address: | 1500 Lansdowne Ave Darby, PA - 190231200 |
Business Phone Number: | 6102374000 |
Business Fax Number: | |
Mailing Address: | 263 Congressional Ln, Apt T9 ROCKVILLE |
State: | MD |
Postal Code: | 208525318 |
Phone Number: | 3014669416 |
Fax Number: | |
NPI Enumeration Date: | 06/06/2013 |
NPI Last Update Date: | 06/06/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |