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Organization

UVATOV PODIATRY PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TATYANA UVATOV DPM (PODIATRIST)
(718) 869-1098
Entity
Organization

Contact information

Practice address
1468 RICHMOND AVE, STATEN ISLAND, NY 10314-1550
(917) 817-8262
Mailing address
145 HENRY PL, STATEN ISLAND, NY 10305-1359
(718) 869-1098

Taxonomy

Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
006193
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02940958
NY
Enumeration date
12/04/2007
Last updated
01/10/2017
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