Provider Demographics
NPI:1639373905
Name:EMPIRE FAMILY MEDICINE
Entity type:Organization
Organization Name:EMPIRE FAMILY MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KIRILL
Authorized Official - Middle Name:
Authorized Official - Last Name:RIKHER
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PHD
Authorized Official - Phone:718-769-0400
Mailing Address - Street 1:3060 OCEAN AVE SUITE LA
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235
Mailing Address - Country:US
Mailing Address - Phone:718-769-0400
Mailing Address - Fax:718-769-0183
Practice Address - Street 1:3060 OCEAN AVE SUITE LA
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235
Practice Address - Country:US
Practice Address - Phone:718-769-0400
Practice Address - Fax:718-769-0183
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY195662OtherLICENC
NY=========OtherTAX ID
NY195662OtherLICENC