Individual
TETYANA DIVINSKIY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
270 PARK AVE, HUNTINGTON, NY 11743-2787
(631) 351-2255
(631) 760-2182
Mailing address
270 PARK AVE, HUNTINGTON, NY 11743-2787
(631) 351-2255
(631) 760-2182
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
276198
NY
Other
Enumeration date
07/06/2011
Last updated
07/30/2015
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