Antonevich, Tatyana
Antonevich, Tatyana is an individual health care provider with primary practice located at 1729 Burrstone Rd , New Hartford NY 13413-1001. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pulmonary Disease, which is considered as her primary health care specialty. Antonevich, Tatyana can be contacted via phone (315) 798-1658.Contact Information
Primary practice address
1729 Burrstone Rd
New Hartford NY 13413-1001
Phone: (315) 798-1658
Fax: (315) 798-1650
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | ME90499 | Florida |
Profile Details
| NPI number | 1528054368 |
|---|---|
| LBN Legal business name | Antonevich, Tatyana |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 27th, 2005 |
| Last updated | Jul 2nd, 2012 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1528054368 | NPPES |
| Florida | MEDICAID | 274104100 |
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