Individual
DR. IVGENIJA FASTOVSKY
Active
Individual
DR. IVGENIJA FASTOVSKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
ME 59109
FL
2084P0805X
Geriatric Psychiatry Physician
Primary
ME 59109
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00580525
—
NY
01
—
P 55311
MEDICARE GHI
NY
Enumeration date
12/10/2008
Last updated
12/10/2008
Update your record
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