Provider Demographics
NPI:1851663397
Name:SHTARKMAN, IGOR (DC)
Entity Type:Individual
Prefix:DR
First Name:IGOR
Middle Name:
Last Name:SHTARKMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:271 MADISON AVE SUITE 1600
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:NY
Mailing Address - Zip Code:10016
Mailing Address - Country:US
Mailing Address - Phone:212-682-6620
Mailing Address - Fax:212-682-6588
Practice Address - Street 1:271 MADISON AVE STE 1600
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-1001
Practice Address - Country:US
Practice Address - Phone:212-682-6620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-30
Last Update Date:2012-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012106111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor