Provider Demographics
NPI:1205873015
Name:UTKIN, ARKADY
Entity type:Individual
Prefix:
First Name:ARKADY
Middle Name:
Last Name:UTKIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 FLAGSHIP CIR
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10309-3979
Mailing Address - Country:US
Mailing Address - Phone:718-227-7481
Mailing Address - Fax:718-732-4558
Practice Address - Street 1:10 FLAGSHIP CIR
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10309-3979
Practice Address - Country:US
Practice Address - Phone:718-227-7481
Practice Address - Fax:718-732-4558
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR057074-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical