Individual provider · Type 1 NPI
Dimitri Fedorov, PA
Medical Physician Assistant · Brooklyn, NY
NPI number
1275495046
Active
Practice location
2148 Ocean Ave Fl 5
Brooklyn, NY 11229-1484
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | None listed |
Medical Physician Assistant: Definition to come...
4 other providers at this address
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About NPI 1275495046
Dimitri Fedorov, PA's National Provider Identifier is 1275495046, issued on Dec 1, 2025. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Brooklyn, NY. The record was last updated on Dec 1, 2025.