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Individual

DMITRIY KATKOVSKIY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.,

Contact information

Practice address
2 W FORDHAM RD, BRONX, NY 10468-5359
(646) 647-1255
Mailing address
1345 RXR PLZ FL 13, UNIONDALE, NY 11556-1301
(516) 453-0435

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
217843
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02159075
NY
Enumeration date
09/29/2006
Last updated
06/05/2019
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