Individual
DR. ANTONINA Y KOLESNIKOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1140 VARNUM ST NE STE 202, WASHINGTON, DC 20017-2153
(202) 269-6430
(202) 269-6598
Mailing address
1140 VARNUM ST NE STE 202, WASHINGTON, DC 20017-2153
(202) 269-6430
(202) 269-6598
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
MD036833
DC
261QP2300X
Primary Care Clinic/Center
D0069258
MD
302F00000X
Exclusive Provider Organization
MD036833
DC
302R00000X
Health Maintenance Organization
D0069258
MD
302R00000X
Health Maintenance Organization
MD036833
DC
305R00000X
Preferred Provider Organization
D0069258
MD
305R00000X
Preferred Provider Organization
MD036833
DC
305S00000X
Point of Service
MD036833
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
055092400
—
DC
05
—
099023600
—
DC
05
—
520060100
—
MD
01
—
D0069258
LICENSE
MD
01
—
MD036833
LICENSE
DC
Enumeration date
05/09/2008
Last updated
10/03/2025
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