Individual
TATYANA D'AVERSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC,MPH
Contact information
Practice address
1320 YORK AVE APT 13R, NEW YORK, NY 10021-4856
(631) 662-0040
Mailing address
1320 YORK AVE APT 13R, NEW YORK, NY 10021-4856
(631) 662-0040
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0123577
NY
Other
Enumeration date
05/05/2020
Last updated
05/05/2020
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