Provider Demographics
NPI:1407222896
Name:ARKADY VAKNANSKY MD PA
Entity Type:Organization
Organization Name:ARKADY VAKNANSKY MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ARKADY
Authorized Official - Middle Name:
Authorized Official - Last Name:VAKNANSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-579-3392
Mailing Address - Street 1:702 KATHLEEN PL
Mailing Address - Street 2:APT 5C
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-5159
Mailing Address - Country:US
Mailing Address - Phone:917-579-3392
Mailing Address - Fax:718-769-7814
Practice Address - Street 1:2114 GRAVESEND NECK RD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-4810
Practice Address - Country:US
Practice Address - Phone:718-769-9100
Practice Address - Fax:718-769-7814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-19
Last Update Date:2016-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty