Provider Demographics
NPI:1295952851
Name:ARKADIEV, VASSILI VALERIEVICH (MD)
Entity type:Individual
Prefix:DR
First Name:VASSILI
Middle Name:VALERIEVICH
Last Name:ARKADIEV
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 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-851-2304
Mailing Address - Fax:717-851-3374
Practice Address - Street 1:1001 S GEORGE ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-3676
Practice Address - Country:US
Practice Address - Phone:717-851-2304
Practice Address - Fax:717-851-3374
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2016-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4402472084P0800X, 2084P0805X, 2084P0805X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102485440Medicaid
PA192980Medicare PIN
PA102485440Medicaid
OHAR4263351Medicare PIN
KY0354113Medicare UPIN
KY0354220Medicare UPIN
KY0354320Medicare UPIN
KY0295615Medicare PIN