Provider Demographics
NPI:1144247149
Name:VILNITS, ANATOLIY (MD)
Entity type:Individual
Prefix:DR
First Name:ANATOLIY
Middle Name:
Last Name:VILNITS
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 1:2202 STEINWAY ST
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11105-1836
Mailing Address - Country:US
Mailing Address - Phone:718-423-0808
Mailing Address - Fax:718-204-6866
Practice Address - Street 1:540 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11217-1985
Practice Address - Country:US
Practice Address - Phone:718-855-4900
Practice Address - Fax:718-802-0631
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-16
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY223076207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02255961Medicaid
NYA400075294Medicare PIN
NYH53605Medicare UPIN