Provider Demographics
NPI:1821019720
Name:MILOSEVIC, MILIVOJE (MD)
Entity Type:Individual
Prefix:DR
First Name:MILIVOJE
Middle Name:
Last Name:MILOSEVIC
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 1:64 NAGLE AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10040-1406
Mailing Address - Country:US
Mailing Address - Phone:646-344-1715
Mailing Address - Fax:917-997-9555
Practice Address - Street 1:3845 10TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10034-1850
Practice Address - Country:US
Practice Address - Phone:463-441-7156
Practice Address - Fax:917-997-9555
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-23
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY144052207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00533793Medicaid
NYB14372Medicare UPIN
NY34597Medicare ID - Type Unspecified