Provider Demographics
NPI:1225431802
Name:AP DIAGNOSTIC LLC
Entity Type:Organization
Organization Name:AP DIAGNOSTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAVEL
Authorized Official - Middle Name:
Authorized Official - Last Name:TELYATNIKOV
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-975-0280
Mailing Address - Street 1:2792 OCEAN AVE
Mailing Address - Street 2:UNIT 5A
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-4729
Mailing Address - Country:US
Mailing Address - Phone:718-975-0280
Mailing Address - Fax:718-975-0639
Practice Address - Street 1:2792 OCEAN AVE
Practice Address - Street 2:UNIT 5A
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-4729
Practice Address - Country:US
Practice Address - Phone:718-975-0280
Practice Address - Fax:718-975-0639
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-26
Last Update Date:2016-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225B00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPulmonary Function TechnologistGroup - Multi-Specialty
No2279P1006XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredPulmonary Function TechnologistGroup - Multi-Specialty