Polovenko-Kallman, Tatyana N.

Polovenko-Kallman, Tatyana N. is an sole proprietor health care provider with primary practice located at 150 55Th St , Brooklyn NY 11220-2559. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is her primary health care specialty. Polovenko-Kallman, Tatyana N. can be contacted via phone (718) 630-7185.

Contact Information

Primary practice address
150 55Th St Brooklyn NY 11220-2559
Phone: (718) 630-7185
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 002312 New York
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 002312 New York

Profile Details

NPI number 1497721450
LBN Legal business name Polovenko-Kallman, Tatyana N.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 28th, 2006
Last updated Jun 11th, 2021 - about 5 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 1497721450 NPPES
New York MEDICAID 02654593
New York Other 299AG1
New York Other P00286376

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