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Canonical ID: NK-X6RbmhdHsdfSfGuWaknoCK · Entity type: LegalEntity (reference)
| Property | Value | Lang | Source dataset | Source ID | First seen | ||
|---|---|---|---|---|---|---|---|
Person:address | 584 FOREST AVE, STATEN ISLAND, NY 103102512 | ext_us_cms_npi | us-npi-1902882038 | ||||
LegalEntity:address | 87 SHREWSBURY DIRVE, LIVINGSTON, NJ 07039 | eng | us_nj_med_exclusions | us-mednj-a6f4fb9429fc545566771ce3b378878134b8b747 | |||
Person:address | 1 EDGEWATER ST, 6TH FL. PAYER RELATIONS, STATEN ISLAND, NY 103054900 | ext_us_cms_npi | us-npi-1902882038 | ||||
LegalEntity:address | 87 SHREWSBURY DRIVE, LIVINGSTON, NJ 07039 | eng | us_nj_med_exclusions | us-mednj-6465a3913c0ab8aeb9f7c0926ce2f632bf2899d8 | |||
LegalEntity:addressEntity | addr-704c4e0d385c62e90361eb5f0a92529bd8cef0a8 | us_nj_med_exclusions | us-mednj-a6f4fb9429fc545566771ce3b378878134b8b747 | ||||
LegalEntity:addressEntity | addr-965f465bc5536ea54163d75cf1302ba43286d20a | us_nj_med_exclusions | us-mednj-6465a3913c0ab8aeb9f7c0926ce2f632bf2899d8 | ||||
Person:country | us | ext_us_cms_npi | us-npi-1902882038 | ||||
LegalEntity:country | us | us_nj_med_exclusions | us-mednj-6465a3913c0ab8aeb9f7c0926ce2f632bf2899d8 | ||||
LegalEntity:country | us | us_ny_med_exclusions | us-medny-28801e09aa0435d291f5630468c770f9f0948d26 | ||||
LegalEntity:country | us | us_nj_med_exclusions | us-mednj-a6f4fb9429fc545566771ce3b378878134b8b747 | ||||
Person:firstName | MICHAEL | ext_us_cms_npi | us-npi-1902882038 | ||||
Person:id | 149ef0fed076885f1b6dc3ac47e09d5fcd730a64 | ext_us_cms_npi | us-npi-1902882038 | ||||
LegalEntity:id | 4cec11bbc7afe4ef4c9d1f4b4bcd68a04b42857b | us_nj_med_exclusions | us-mednj-6465a3913c0ab8aeb9f7c0926ce2f632bf2899d8 | ||||
LegalEntity:id | fa11b8363b81dfcec41e0c8ded65dffa07f3e7a8 | us_ny_med_exclusions | us-medny-28801e09aa0435d291f5630468c770f9f0948d26 | ||||
LegalEntity:id | 0c5ef60be703af7558acb18bd65949f8ff388a4a | us_nj_med_exclusions | us-mednj-a6f4fb9429fc545566771ce3b378878134b8b747 | ||||
LegalEntity:idNumber | 00180877 | eng | us_ny_med_exclusions | us-medny-28801e09aa0435d291f5630468c770f9f0948d26 | |||
Person:lastName | TYSHKOV | ext_us_cms_npi | us-npi-1902882038 | ||||
LegalEntity:name | TYSHKOV MICHAEL | eng | us_ny_med_exclusions | us-medny-28801e09aa0435d291f5630468c770f9f0948d26 | |||
LegalEntity:name | TYSHOV, MICHAEL | eng | us_nj_med_exclusions | us-mednj-a6f4fb9429fc545566771ce3b378878134b8b747 | |||
LegalEntity:name | TYSHKOV, MICHAEL | eng | us_nj_med_exclusions | us-mednj-6465a3913c0ab8aeb9f7c0926ce2f632bf2899d8 | |||
Person:name | MICHAEL TYSHKOV | ext_us_cms_npi | us-npi-1902882038 | ||||
LegalEntity:npiCode | 1902882038 | eng | us_nj_med_exclusions | us-mednj-a6f4fb9429fc545566771ce3b378878134b8b747 | |||
LegalEntity:npiCode | 1902882038 | eng | us_ny_med_exclusions | us-medny-28801e09aa0435d291f5630468c770f9f0948d26 | |||
LegalEntity:npiCode | 1902882038 | eng | us_nj_med_exclusions | us-mednj-6465a3913c0ab8aeb9f7c0926ce2f632bf2899d8 | |||
Person:npiCode | 1902882038 | ext_us_cms_npi | us-npi-1902882038 | ||||
LegalEntity:sector | Physician | eng | us_ny_med_exclusions | us-medny-28801e09aa0435d291f5630468c770f9f0948d26 | |||
LegalEntity:sector | MD | eng | us_nj_med_exclusions | us-mednj-a6f4fb9429fc545566771ce3b378878134b8b747 | |||
LegalEntity:sector | MD | eng | us_nj_med_exclusions | us-mednj-6465a3913c0ab8aeb9f7c0926ce2f632bf2899d8 | |||
Person:title | DR. | ext_us_cms_npi | us-npi-1902882038 | ||||
LegalEntity:topics | debarment | us_nj_med_exclusions | us-mednj-6465a3913c0ab8aeb9f7c0926ce2f632bf2899d8 | ||||
LegalEntity:topics | debarment | us_nj_med_exclusions | us-mednj-a6f4fb9429fc545566771ce3b378878134b8b747 | ||||
LegalEntity:topics | debarment | us_ny_med_exclusions | us-medny-28801e09aa0435d291f5630468c770f9f0948d26 | ||||