Individual
TATYANA R GITLEVICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
19 BRADHURST AVE STE 3850, HAWTHORNE, NY 10532-2199
(914) 345-1313
(913) 345-5004
Mailing address
19 BRADHURST AVE STE 3100N, HAWTHORNE, NY 10532-2140
(914) 909-9018
Taxonomy
Speciality
Code
Description
License number
State
2084E0001X
Epilepsy Physician
230302
NY
2084N0400X
Neurology Physician
Primary
230302
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02578476
—
NY
Enumeration date
07/28/2005
Last updated
01/30/2025
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