Organization
NOVA MEDICAL ARTS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
INESSA SVISTUNOVA DO (PRESIDENT)
(917) 705-3664
Entity
Organization
Contact information
Practice address
520 NEPTUNE AVE, BROOKLYN, NY 11224-4004
(718) 333-9070
(718) 333-9060
Mailing address
170 AVENUE C, SUITE 6E, NEW YORK, NY 10009-4206
(917) 705-3664
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
268070
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1457519126
NPI
NY
Enumeration date
01/24/2015
Last updated
01/24/2015
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