Provider Demographics
NPI:1740527845
Name:PINKHASOV, ARTEM (PAC)
Entity type:Individual
Prefix:
First Name:ARTEM
Middle Name:
Last Name:PINKHASOV
Suffix:
Gender:M
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4232 FRANCIS LEWIS BLVD LOWR LEVEL
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11361-2561
Mailing Address - Country:US
Mailing Address - Phone:718-750-1665
Mailing Address - Fax:
Practice Address - Street 1:4232 FRANCIS LEWIS BLVD LOWR LEVEL
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11361-2561
Practice Address - Country:US
Practice Address - Phone:718-750-1665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-09
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY0162681363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical