Provider Demographics
NPI:1588631345
Name:Y FILL SLUKHINSKY
Entity Type:Organization
Organization Name:Y FILL SLUKHINSKY
Other - Org Name:ARTHRITIS AND PAIN REHAB CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:YEKATRINA
Authorized Official - Middle Name:FILL
Authorized Official - Last Name:SLUKHINSKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-332-6946
Mailing Address - Street 1:3043 OCEAN AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-3497
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3043 OCEAN AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-3497
Practice Address - Country:US
Practice Address - Phone:718-332-6946
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-01
Last Update Date:2008-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY167572174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01020846Medicaid
NY02E531Medicare ID - Type Unspecified
NYA96935Medicare UPIN