Organization
KOLESNIKOV PEDIATRICS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREY KOLESNIKOV (OWNER)
(980) 565-9500
Entity
Organization
Contact information
Practice address
120 PONDEROSA DR, JENKINS, KY 41537
(980) 565-9500
Mailing address
PO BOX 60623, STATEN ISLAND, NY 10306-0623
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
287701
NY
Other
Enumeration date
12/21/2017
Last updated
12/21/2017
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