OLEG KOTELSKIY D.O. NPI 1003871179

Family Medicine in Brooklyn, NY

About OLEG KOTELSKIY

Oleg Kotelskiy is a provider in Brooklyn, NY with more than 23 years of experience. The NPI number assigned to this provider is 1003871179. The practitioner's primary taxonomy code is Family Medicine (207Q00000X). The provider is registered as an individual and their NPI record was last updated 10 years ago. Oleg Kotelskiy is registered with Medicare and accepts claims assignment.

NPI1003871179 Additional informationCallout TooltipNational Provider Indentifier (NPI)
The 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider Name OLEG KOTELSKIY D.O.
Provider Location Address3816 NOSTRAND AVE BROOKLYN, NY 11235 Additional informationCallout TooltipProvider location address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address3816 NOSTRAND AVE BROOKLYN, NY 11235 Additional informationCallout TooltipProvider mailing address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
GenderMale
NPI Entity TypeIndividual Additional informationCallout TooltipEntity type code
The code describing the type of health care provider that is being assigned an NPI.
Codes are:
1 = (Person): individual human being who furnishes health care;
2 = (Non-person): entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO).
Medical School NameNEW YORK COLLEGE OF OSTEO MEDICINE OF NEW YORK INSTITUTE OF TECHNOLOGY
Graduation Year1995
Is Sole Proprietor?Yes
Is Organization Subpart?N/A Additional informationCallout TooltipWhat is a subpart?
Subparts are the components and separate physical locations of organization health care providers. Examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Enumeration Date04-19-2006 Additional informationCallout TooltipProvider enumeration date
The date the provider was assigned a unique identifier (assigned an NPI)
Last Update Date07-08-2007 Additional informationCallout TooltipLast update date
The date that a record was last updated or changed.

Business Address

OLEG KOTELSKIY D.O.
3816 NOSTRAND AVE
BROOKLYN, NY
ZIP 11235
Phone: (718) 338-2323
Fax: (718) 338-7117
Get Directions

Mailing Address

OLEG KOTELSKIY D.O.
3816 NOSTRAND AVE
BROOKLYN, NY
ZIP 11235
Phone: (718) 338-2323
Fax: (718) 338-7117

Primary Taxonomy

Taxonomy Code207Q00000X Additional informationCallout TooltipPrimary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
ClassificationFamily Medicine
TypeAllopathic & Osteopathic Physicians
License No.2050591
License StateNY
Taxonomy DescriptionFamily Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
614141MEDICARE ID-TYPE UNSPECIFIED (04)NY
2050591OTHER (01)NY
G44763MEDICARE UPIN (02)NY
01749417MEDICAID (05)NY

Map Location


OLEG KOTELSKIY D.O. address is 3816 NOSTRAND AVE BROOKLYN, NY 11235

Other Providers at the same location


The following provider is registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1508907510OLEG KOTELSKIY D.O., P.C.
Organization
Family Medicine3816 NOSTRAND AVE
BROOKLYN, NY 11235
(347) 713-6871