Tyshkov, Michael

Tyshkov, Michael is an individual health care provider with primary practice located at 584 Forest Ave , Staten Island NY 10310-2512. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Gastroenterology, which is considered as his primary health care specialty. Tyshkov, Michael can be contacted via phone (718) 226-5619.

Contact Information

Primary practice address
584 Forest Ave Staten Island NY 10310-2512
Phone: (718) 226-5619
Fax: (718) 226-5620
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Gastroenterology 2080P0206X 180877 New York

Profile Details

NPI number 1902882038
LBN Legal business name Tyshkov, Michael
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 20th, 2005
Last updated Dec 31st, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902882038 NPPES
New York MEDICAID 01268262
New York MEDICAID 5341400

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