Provider Demographics
NPI:1063859312
Name:MIHATOV, NINO (MD)
Entity Type:Individual
Prefix:DR
First Name:NINO
Middle Name:
Last Name:MIHATOV
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 6TH STREET
Mailing Address - Street 2:KP-2 DIVISION OF CARDIOLOGY
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-3609
Mailing Address - Country:US
Mailing Address - Phone:718-780-5300
Mailing Address - Fax:718-780-5350
Practice Address - Street 1:506 6TH STREET
Practice Address - Street 2:KP-2 DIVISION OF CARDIOLOGY
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-3609
Practice Address - Country:US
Practice Address - Phone:718-780-5300
Practice Address - Fax:718-780-5350
Is Sole Proprietor?:No
Enumeration Date:2013-05-28
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA264765207R00000X, 208M00000X
NY304144207RC0000X, 207RI0011X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist