Doctor profile · Federal record
Dr. Gennadiy Shamalov, PA
Surgical Physician Assistant · Briarwood, NY
- NPI 1174670319
- 19 yrs on file
- Male
- Solo practice
- No sanctions
Practice & contact
- Primary practice
-
141-23 Hoover Ave
Briarwood, NY 114351604
(917) 709-4733
Credentials & registration
- NPI registered
- January 2007 — 19 yrs on file
- Profile last updated
- September 25, 2012
- Specialty taxonomy
- 363AS0400X — NUCC code
- State license (1)
- New York #008219-1
Federal sanctions & exclusions
No sanctions, exclusions or revocations on file
Checked against OIG LEIE on NPI 1174670319. Last verified May 11, 2026.Open Payments
Industry payments received
All-time total
$142
Transactions
1
Manufacturers
1
| Payer (manufacturer) | Industry | Txns | Amount |
|---|---|---|---|
| Suvon Surgical Llc | 1 | $141.83 |
By nature of payment
Frequently asked questions
What is Dr. Gennadiy Shamalov's medical specialty?
Dr. Gennadiy Shamalov practices Surgical Physician Assistant in Briarwood, NY.
Where does Dr. Gennadiy Shamalov practice?
Dr. Gennadiy Shamalov practices at 141-23 Hoover Ave, Briarwood, NY 114351604. Office phone: 9177094733.
What is Dr. Gennadiy Shamalov's NPI?
Dr. Gennadiy Shamalov's National Provider Identifier (NPI) is 1174670319, issued by NPPES.