Provider Demographics
NPI:1346928389
Name:ZHMAKIN, VLADISLAV (MD)
Entity Type:Individual
Prefix:
First Name:VLADISLAV
Middle Name:
Last Name:ZHMAKIN
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:WATERBURY HOSPITAL 64 ROBBINS STREET
Mailing Address - Street 2:WATERBURY, CT 06708
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06708
Mailing Address - Country:US
Mailing Address - Phone:203-773-6162
Mailing Address - Fax:
Practice Address - Street 1:CHASE OUTPATIENT CENTER 160 ROBBINS STREET
Practice Address - Street 2:WATERBURY, CT 06708
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708
Practice Address - Country:US
Practice Address - Phone:203-573-7284
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program