Individual
DR. DIMA RASKOLNIKOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1250 WATERS PL PH, BRONX, NY 10461-2720
(718) 920-4531
Mailing address
1250 WATERS PL PH, BRONX, NY 10461-2720
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
316573
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1790172500
—
WA
Enumeration date
04/20/2015
Last updated
08/07/2022
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