Provider Demographics
NPI:1982659660
Name:KIRPICHNIKOV, DMITRI (MD)
Entity Type:Individual
Prefix:DR
First Name:DMITRI
Middle Name:
Last Name:KIRPICHNIKOV
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 1:2606 HARING ST FL 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-1606
Mailing Address - Country:US
Mailing Address - Phone:718-645-6434
Mailing Address - Fax:718-382-5252
Practice Address - Street 1:2269 OCEAN AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-3103
Practice Address - Country:US
Practice Address - Phone:718-339-8200
Practice Address - Fax:718-382-5252
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY214769207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY3X0582Medicare PIN
NYH43646Medicare UPIN
NY3X0581Medicare PIN