Individual
TATYANA UVATOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
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
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
006193
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02882722
—
NY
Enumeration date
12/02/2006
Last updated
01/10/2017
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