Ivan Antonevich MD

NPI 1043256118 - Anesthesiology - 207L00000X

NPI Details
NPI 1043256118
Gender Male
Enumeration Date 06/20/2006
Last Updated 07/02/2012
Entity Type Individual
Active Over 10 years ago
Practice Location
1729 BURRSTONE RD
NEW HARTFORD NY, 13413-1001, US
Phone (315) 798-1567
Fax (315) 798-1565
Business Location
1729 BURRSTONE RD
NEW HARTFORD NY, 13413-1001, US
Phone (315) 798-1567
Fax (315) 798-1565
Toxanomy
Taxonomy Code 207L00000X
License State Florida
License Number ME90635
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According to our database, Dr. Ivan Antonevich MD NPI is 1043256118, taxonomy code is 207L00000X and license number is ME90635, license state is located at Florida. Ivan Antonevich MD physically located at 1729 Burrstone Rd, New Hartford NY, 13413-1001. NPI Number Ivan Antonevich MD has the Individual type.

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1043256118 NPI number is provided on an as is basis without warranty of any kind. 1043256118 is maintained by the National Plan & Provider Enumeration System. The contents of Ivan Antonevich MD are for informational purposes only.