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NPI 1902205933 · Exclusive Provider Organization · Brooklyn, NY
Provider details
- NPI number
- 1902205933
- Entity type
- Organization
- Primary specialty
- Exclusive Provider OrganizationManaged Care Organizations
- Organization subpart
- No
- Authorized official
- Oleg Rybalov, President(917) 417-7344
- License
- 022591 (NY)
Specialties & taxonomies
Managed Care Organizations
Practice location
2388 Ocean Ave
Apt. 7
Brooklyn, NY 11229-3564
Phone: (917) 417-7344
Approximate (ZIP-level) locationGet directions
Mailing address
2388 Ocean Ave
Brooklyn, NY 11229-3564
Registry dates
- Enumerated
- 2014-08-14
- Last updated
- 2014-08-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.