Type | Legal entity | [sources] | |||
---|---|---|---|---|---|
Name | TYSHKOV MICHAEL · TYSHKOV, MICHAEL · TYSHOV, MICHAEL | [sources] | |||
Legal form | not available | [sources] | |||
Country | United States of America | [sources] | |||
ID Number | 00180877 | [sources] | |||
NPI | 1902882038 | [sources] | |||
Sector | MD · Physician | [sources] | |||
Status | not available | [sources] | |||
Address | 87 SHREWSBURY DIRVE, LIVINGSTON, NJ 07039 · 87 SHREWSBURY DRIVE, LIVINGSTON, NJ 07039 | [sources] | |||
Last change | Last processed | First seen |
Medical providers deemed ineligible to participate in New York State's Medicaid program.
United States of America · OMIG
Medical providers disqualified from participating in New Jersey State's Medicaid program.
United States of America · OIFP
us-mednj-a6f4fb9429fc545566771ce3b378878134b8b747
· us-mednj-6465a3913c0ab8aeb9f7c0926ce2f632bf2899d8
· us-medny-28801e09aa0435d291f5630468c770f9f0948d26
For experts: raw data explorer
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Sanctions | |||||
---|---|---|---|---|---|
Country | Authority | Program | Start date | End date | |
United States of America | New Jersey Office of the State Comptroller | - |
Address | ||
---|---|---|
Full address | Country | |
87 SHREWSBURY DIRVE, LIVINGSTON, NJ 07039 | United States of America |
United States of America | New York State Office of the Medicaid Inspector General | - | - |
United States of America | New Jersey Office of the State Comptroller | - | - |
87 SHREWSBURY DRIVE, LIVINGSTON, NJ 07039 | United States of America |