REGISTERED PHYSICIAN ASSISTANT FIRST ASSIST PC
NPI 1164753182
Physician Assistant - Surgical in Briarwood, NY

Active since January 15, 2010
13876 QUEENS BLVD, 1ST FLOOR, BRIARWOOD, NY 11435(718) 850-6345 Get Directions Write a Review

NPPES record last updated: January 15, 2010. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Registered Physician Assistant First Assist Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

REGISTERED PHYSICIAN ASSISTANT FIRST ASSIST PC (NPI 1164753182) is a healthcare organization registered as a surgical in Briarwood, New York and active in the NPI registry since January 2010. The organization lists Gennadiy Shamalov, Physician Assistant, as its authorized official.

NPPES Registry Identity

NPI1164753182
Entity TypeOrganization
Primary Taxonomy363AS0400X
Legal Business NameREGISTERED PHYSICIAN ASSISTANT FIRST ASSIST PC
Location Address13876 QUEENS BLVD, 1ST FLOORBriarwood, NY 11435-2930
Mailing Address14123 Hoover AveBriarwood, NY 11435-1109 · (917) 709-4733
Organization SubpartNo
Authorized OfficialGennadiy ShamalovPhysician Assistant · (917) 709-4733
Enumeration DateJanuary 15, 2010
NPI 1164753182 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AS0400X
License Licensed in NY · 008219
13876 QUEENS BLVD, Briarwood, NY 11435

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 8

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Family Medicine (Adult Medicine)
13876 QUEENS BLVD, 1ST FLOOR
BRIARWOOD, NY 11435
Family Medicine
13876 QUEENS BLVD, 1ST FLOOR
BRIARWOOD, NY 11435
Obstetrics & Gynecology (Gynecology)
13876 QUEENS BLVD, 1ST FLOOR
BRIARWOOD, NY 11435
Internal Medicine
13876 QUEENS BLVD, 1ST FLOOR
BRIARWOOD, NY 11435
Nurse Practitioner (Adult Health)
13876 QUEENS BLVD, 1ST FLOOR
BRIARWOOD, NY 11435
Family Medicine
13876 QUEENS BLVD, 1ST FLOOR
BRIARWOOD, NY 11435
Internal Medicine
13876 QUEENS BLVD, 1ST. FLOOR
BRIARWOOD, NY 11435
Clinic/Center (Community Health)
13876 QUEENS BLVD, 1ST FLOOR
BRIARWOOD, NY 11435

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1164753182, enumerated as an "organization" on January 15, 2010.

The provider is located at 13876 QUEENS BLVD 1ST FLOOR BRIARWOOD, NY 11435 and the phone number is (718) 850-6345.

Physician Assistant with taxonomy code 363AS0400X and a focus in Surgical.