Vysotskyy, Taras

Vysotskyy, Taras is an individual health care provider with primary practice located at 45 Richmond Blvd Unit 2A, Ronkonkoma NY 11779-3622. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Vysotskyy, Taras can be contacted via phone (516) 695-0112.

Contact Information

Primary practice address
45 Richmond Blvd Unit 2A Ronkonkoma NY 11779-3622
Phone: (516) 695-0112
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 005677 New York

Profile Details

NPI number 1962810036
LBN Legal business name Vysotskyy, Taras
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 1st, 2014
Last updated Apr 17th, 2017 - about 9 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 1962810036 NPPES
New York MEDICAID 005677

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