Individual
ALEKSANDR KAPUSTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
140 OXFORD ST, BROOKLYN, NY 11235-2311
(917) 589-5502
Mailing address
140 OXFORD ST, BROOKLYN, NY 11235-2311
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1600
NEW YORK STATE DEPARTMENT OF HEALTH
NY
Enumeration date
10/29/2015
Last updated
10/29/2015
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