Fastovsky, Ivgenija

Fastovsky, Ivgenija is an sole proprietor health care provider with primary practice located at 19111 Collins Ave Apt 2505 , Sunny Isles Beach FL 33160-2384. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Geriatric Psychiatry. Allopathic & Osteopathic Physicians / Geriatric Psychiatry is her primary health care specialty. Fastovsky, Ivgenija can be contacted via phone (305) 933-6873.

Contact Information

Primary practice address
19111 Collins Ave Apt 2505 Sunny Isles Beach FL 33160-2384
Phone: (305) 933-6873
Fax: (305) 933-6873
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X ME 59109 Florida
Allopathic & Osteopathic Physicians / Geriatric Psychiatry 2084P0805X ME 59109 Florida

Profile Details

NPI number 1043455645
LBN Legal business name Fastovsky, Ivgenija
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 10th, 2008
Last updated Dec 10th, 2008 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043455645 NPPES
New York Other P 55311 MEDICARE GHI
New York MEDICAID 00580525 MEDICARE GHI

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