Provider Demographics
NPI:1689979635
Name:SVYATKOVSKY, VIKTOR (RPA-C)
Entity Type:Individual
Prefix:MR
First Name:VIKTOR
Middle Name:
Last Name:SVYATKOVSKY
Suffix:
Gender:M
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 UNION SQUARE EAST BETH ISRAEL MEDICAL CENTER
Mailing Address - Street 2:DEPARTMENT OF ORTHOPEDICS SUITE 3M
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003
Mailing Address - Country:US
Mailing Address - Phone:212-844-6970
Mailing Address - Fax:
Practice Address - Street 1:10 UNION SQUARE EAST BETH ISRAEL MEDICAL CENTER
Practice Address - Street 2:DEPARTMENT OF ORTHOPEDICS SUITE 3M
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003
Practice Address - Country:US
Practice Address - Phone:212-844-6970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-24
Last Update Date:2011-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014270363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical