Individual
TETYANA KOULIKOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
2272 63RD ST APT 2F, BROOKLYN, NY 11204-3153
(929) 441-0536
Mailing address
2272 63RD ST APT 2F, BROOKLYN, NY 11204-3153
(929) 441-0536
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
019051
NY
208600000X
Surgery Physician
Primary
019051
NY
208800000X
Urology Physician
019051
NY
Other
Enumeration date
09/20/2015
Last updated
09/03/2019
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