Individual
NATIA PANTSULAIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12 N 7TH AVE, MOUNT VERNON, NY 10550-2026
(914) 664-8000
Mailing address
12 N 7TH AVE, MOUNT VERNON, NY 10550-2026
(914) 664-8000
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
281584
NY
Other
Enumeration date
08/14/2014
Last updated
04/29/2019
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