Provider Demographics
NPI:1629094495
Name:SHPITALNIK, VILOR (MD)
Entity Type:Individual
Prefix:DR
First Name:VILOR
Middle Name:
Last Name:SHPITALNIK
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 1:1723 E 12TH ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-1069
Mailing Address - Country:US
Mailing Address - Phone:718-615-7450
Mailing Address - Fax:718-615-7452
Practice Address - Street 1:1723 E 12TH ST
Practice Address - Street 2:SUITE 202
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-1069
Practice Address - Country:US
Practice Address - Phone:718-615-7450
Practice Address - Fax:718-615-7452
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1952952084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01497781Medicaid
NY195295-B16OtherHEALTH FIRST
NY000101430101OtherHEALTH PLUS
NY3186164OtherGHI
NY641251525OtherCENTER CARE
NYN216289OtherWELL CARE
NYP376493OtherOXFORD
NYBK0030902OtherAMERICHOICE
NY157096000OtherMAGELLAN
NY5311103OtherAETNA
NY085597MHSOtherVALUE OPTIONS
NY193734OtherMHN
NY92M99OtherEMPIRE BLUE CROSS BLUE SH
NY195295-B16OtherHEALTH FIRST
NY000101430101OtherHEALTH PLUS
NY641251525OtherCENTER CARE