Provider Demographics
NPI:1124078514
Name:MURDAKHAYEV, RADIK (PA)
Entity type:Individual
Prefix:
First Name:RADIK
Middle Name:
Last Name:MURDAKHAYEV
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5464
Mailing Address - Street 2:PARK SLOPE EMERGENCY PHYSICIAN SERVICES
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10087-5464
Mailing Address - Country:US
Mailing Address - Phone:800-777-2455
Mailing Address - Fax:610-617-6280
Practice Address - Street 1:506 6TH ST
Practice Address - Street 2:NEW YORK METHODIST HOSPITAL
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-3609
Practice Address - Country:US
Practice Address - Phone:718-780-3159
Practice Address - Fax:718-780-7380
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY010908363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical