Provider Demographics
NPI:1427011121
Name:PINKUSOVICH, SVETLANA (MD)
Entity Type:Individual
Prefix:DR
First Name:SVETLANA
Middle Name:
Last Name:PINKUSOVICH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1840 E 14TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-2800
Mailing Address - Country:US
Mailing Address - Phone:718-680-1600
Mailing Address - Fax:718-680-4473
Practice Address - Street 1:8712 4TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209-5110
Practice Address - Country:US
Practice Address - Phone:718-680-1600
Practice Address - Fax:718-680-4473
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-11
Last Update Date:2018-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY202567207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY11-3552139OtherUNITED HEALTH CARE
NY01655430Medicaid
NY3C2622OtherHEALTH NET PPO
NYW3E231OtherMULTIPLAN
NY01655430OtherAETNA HMO
NY2109363OtherCIGNA
NY2594636OtherGHI
NY5526573OtherAETNA PPO, EPO
NY11-3552139Other1199 NBF
NY202567OtherHIP
NY3C2677OtherGUARDIAN
NY000272370301OtherHEALTH PLUS
NY63C631OtherEMPIRE BC/BS
NYP934579OtherOXFORD