Provider Demographics
NPI:1346074705
Name:DMITRIY GEKHMAN, M.D., P.L.L.C.
Entity type:Organization
Organization Name:DMITRIY GEKHMAN, M.D., P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DMITRIY
Authorized Official - Middle Name:
Authorized Official - Last Name:GEKHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-433-0411
Mailing Address - Street 1:303 5TH AVE RM 1705
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-6641
Mailing Address - Country:US
Mailing Address - Phone:212-433-0411
Mailing Address - Fax:
Practice Address - Street 1:111 W 24TH ST STE 300
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-1912
Practice Address - Country:US
Practice Address - Phone:646-859-2339
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-28
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty