Provider Demographics
NPI:1720401169
Name:CHORBA, NATALIYA (MS)
Entity Type:Individual
Prefix:
First Name:NATALIYA
Middle Name:
Last Name:CHORBA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1818 AVENUE L
Mailing Address - Street 2:1G
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-4459
Mailing Address - Country:US
Mailing Address - Phone:646-400-1580
Mailing Address - Fax:
Practice Address - Street 1:1818 AVENUE L
Practice Address - Street 2:1G
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-4459
Practice Address - Country:US
Practice Address - Phone:646-400-1580
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-21
Last Update Date:2014-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY890951174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist