Individual
DR. VIKTOR B SMIRNOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 OLD COUNTRY RD STE 101, MINEOLA, NY 11501-4112
(516) 741-4138
Mailing address
30 MERRICK AVE, EAST MEADOW, NY 11554
(516) 794-0444
(516) 542-0414
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
15973
NY
2086S0129X
Vascular Surgery Physician
15973-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00972743
—
NY
Enumeration date
10/31/2006
Last updated
05/03/2023
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