Provider Demographics
NPI:1629644349
Name:SVETLANA PYATIGORSKAYA NP IN FAMILY HEALTH
Entity Type:Organization
Organization Name:SVETLANA PYATIGORSKAYA NP IN FAMILY HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SVETLANA
Authorized Official - Middle Name:
Authorized Official - Last Name:PYATIGORSKAYA
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:917-589-5855
Mailing Address - Street 1:1850 OCEAN PKWY APT E10
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-3021
Mailing Address - Country:US
Mailing Address - Phone:917-589-5855
Mailing Address - Fax:347-521-2939
Practice Address - Street 1:104 W 14TH ST STE 2A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-7331
Practice Address - Country:US
Practice Address - Phone:212-763-3323
Practice Address - Fax:347-521-2939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-02
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral PracticeGroup - Single Specialty