Organization
TATIANA A PAVLOVA MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TATIANA A PAVLOVA MD, PHD (MEDICAL DIRECTOR)
(212) 569-5330
Entity
Organization
Contact information
Practice address
4738 BROADWAY, NEW YORK, NY 10040-1103
(212) 569-5331
(212) 569-5330
Mailing address
4738 BROADWAY, NEW YORK, NY 10040-1103
(212) 569-5330
(212) 569-5331
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
224668
NY
Other
Enumeration date
12/15/2011
Last updated
12/15/2011
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