Provider Demographics
NPI:1316028582
Name:VOSKIN, SERGEY (MD)
Entity type:Individual
Prefix:DR
First Name:SERGEY
Middle Name:
Last Name:VOSKIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:SERGEY
Other - Middle Name:
Other - Last Name:VOSKRESENSKIY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2116 AVENUE P
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-1507
Mailing Address - Country:US
Mailing Address - Phone:718-704-8665
Mailing Address - Fax:718-333-8189
Practice Address - Street 1:2116 AVENUE P
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-1507
Practice Address - Country:US
Practice Address - Phone:718-704-8665
Practice Address - Fax:718-333-8189
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2010-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY226577208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00246075Medicaid
NYI26135Medicare UPIN