Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Gennadiy Shamalov, PA

Individual provider Surgical Physician Assistant · NPI 1174670319

Gennadiy Shamalov, PA is a Surgical Physician Assistant in Briarwood, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2007
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

See every abbreviation used in this directory →

Practice location Address checks out

141-23 Hoover Ave
Briarwood, NY 11435-1604
Phone: (917) 709-4733
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 008219-1 (NY)

Record details

NPI number1174670319
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorYes
NPI enumeratedJanuary 3, 2007
Last updated in NPPESSeptember 25, 2012

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