Provider Demographics
NPI:1942409768
Name:GATEVA, EVA (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:EVA
Middle Name:
Last Name:GATEVA
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3671 HUDSON MANOR TER
Mailing Address - Street 2:5D
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-1137
Mailing Address - Country:US
Mailing Address - Phone:718-601-6226
Mailing Address - Fax:
Practice Address - Street 1:250 W 49TH ST
Practice Address - Street 2:STE 503
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-7400
Practice Address - Country:US
Practice Address - Phone:212-586-2100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-12
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY223744-1208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice