Individual
DR. TATYANA ANTONEVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2 ELLINWOOD DR, NEW HARTFORD, NY 13413-1102
(315) 624-5960
(315) 849-5923
Mailing address
2 ELLINWOOD DR, NEW HARTFORD, NY 13413-1102
(315) 624-5960
(315) 624-5960
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
ME90499
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
274104100
—
FL
Enumeration date
09/27/2005
Last updated
12/08/2025
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