Search › New York › 363LA2200X
Evgeny Antonov
NPI 1376930156 · on the registry since 2015 · sole proprietor
Practice
- Address
- 56 Foster Rd
Staten Island, NY 10309 - Phone
- (718) 605-6767
- Clinicians at this address
- 2
Registry record
- Primary taxonomy
- 363LA2200X
363LA2200X
- Also registered as
- 163W00000X
363LA2200X - Licence states on file
- NY, FL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2026-07-22
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in New York