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Vadim Orlov

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

PECOS Enrollment

Based on the most recent information from CMS, provider Vadim Orlov is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records today at 9:43 AM.

Profile Details

Provider ID
1174809776
Provider Type
Individual
Full Name
Orlov, Vadim
Title
Mr.
Credential
PA-C

Gender
Male
Sole Proprietor
Yes
Enumeration Date
10/26/2011
Last Updated
10/26/2011

Contact Information

Practice Location

150 55th St, Brooklyn, NY 11220-2553

(718) 630-7425

Unlisted Fax

Mailing Location

14 Albion Pl, Staten Island, NY 10302-1817

(718) 876-5416

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 010502-1 New York
Code 363AM0700X	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 010502-1 New York

Vadim Orlov

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Mendoza, Rowena

Love, Sophia Rose

Krepshaw, Nicholas Brady

Jones-Cruz, Debra Cynthia

Lin, Anita

Shenk-Foley, Tyler

Ho, Teresa

Campbell Gal, Carlene A.

Cohen, Osnat

Chen, William