Individual
DR. TATYANA KIZELSHTEYN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2134 BARNES AVE, BRONX, NY 10462-1902
(718) 828-3663
(718) 828-3154
Mailing address
2134 BARNES AVE, BRONX, NY 10462-1902
(718) 828-3663
(718) 828-3154
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
171414
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01028160
—
NY
Enumeration date
08/01/2006
Last updated
06/10/2015
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