Provider Demographics
NPI:1700202140
Name:PICHKAR, VLADIMIR ALEXANDER (PA-C)
Entity Type:Individual
Prefix:
First Name:VLADIMIR
Middle Name:ALEXANDER
Last Name:PICHKAR
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:86 BAY 26TH ST
Mailing Address - Street 2:APT B1
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-4948
Mailing Address - Country:US
Mailing Address - Phone:212-420-2885
Mailing Address - Fax:212-844-1762
Practice Address - Street 1:317 EAST 17 STREET
Practice Address - Street 2:2ND FLOOR
Practice Address - City:NY
Practice Address - State:NY
Practice Address - Zip Code:10003
Practice Address - Country:US
Practice Address - Phone:212-420-2885
Practice Address - Fax:212-844-1762
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-10
Last Update Date:2014-03-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY010925363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical