Tatiana A Pavlova Md

NPI 1235408576 - Clinic/Center - 261Q00000X

NPI Details
NPI 1235408576
Enumeration Date 12/15/2011
Last Updated 12/15/2011
Entity Type Healthcare Provider
Active Over 4 years ago
Authorized Information
Name TATIANA A TATIANA
Position MEDICAL DIRECTOR
Phone (212) 569-5331
Fax (212) 569-5330
Practice Location
4738 BROADWAY
NEW YORK NY, 10040-1103, US
Phone (212) 569-5331
Fax (212) 569-5330
Business Location
4738 BROADWAY
NEW YORK NY, 10040-1103, US
Phone (212) 569-5330
Fax (212) 569-5331
Toxanomy
Taxonomy Code 261Q00000X
License State New York
License Number 224668
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According to our database, Tatiana A Pavlova Md NPI is 1235408576, taxonomy code is 261Q00000X and license number is 224668, license state is located at New York. Tatiana A Pavlova Md physically located at 4738 Broadway, New York NY, 10040-1103. NPI Number 1033115704 has the healthcare provider type.

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1235408576 NPI number is provided on an as is basis without warranty of any kind. 1235408576 is maintained by the National Plan & Provider Enumeration System. The contents of Tatiana A Pavlova Md are for informational purposes only.