Individual
DR. JANA IVANIDZE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD, PHD
Contact information
Practice address
525 E 68TH ST, NEW YORK, NY 10065
(212) 746-4587
Mailing address
525 E 68TH ST, NEW YORK, NY 10065-4870
(212) 746-4587
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
286362-1
NY
Other
Enumeration date
08/25/2011
Last updated
04/18/2023
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