Provider Demographics
NPI:1194912907
Name:ART OF MEDICINE, P.C.
Entity type:Organization
Organization Name:ART OF MEDICINE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRY
Authorized Official - Prefix:DR
Authorized Official - First Name:INNA
Authorized Official - Middle Name:N
Authorized Official - Last Name:YURYEV-GOLGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-444-7774
Mailing Address - Street 1:2409 OCEAN AVE UNIT 1F
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-3576
Mailing Address - Country:US
Mailing Address - Phone:718-444-7774
Mailing Address - Fax:718-444-7775
Practice Address - Street 1:2409 OCEAN AVE UNIT 1F
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-3576
Practice Address - Country:US
Practice Address - Phone:718-444-7774
Practice Address - Fax:718-444-7775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-26
Last Update Date:2018-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY205385-12084P0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction PsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01765806Medicaid
NY01765806Medicaid