Provider Demographics
NPI:1982010740
Name:SEMYENOVA, NATALIA I
Entity Type:Individual
Prefix:
First Name:NATALIA
Middle Name:
Last Name:SEMYENOVA
Suffix:I
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:NATALIA
Other - Middle Name:IGOREVNA
Other - Last Name:SEMYENOVA
Other - Suffix:I
Other - Last Name Type:Former Name
Other - Credentials:NURSE PRACTITIONER
Mailing Address - Street 1:5251 BARBER RD
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:NY
Mailing Address - Zip Code:14784-9738
Mailing Address - Country:US
Mailing Address - Phone:716-595-3277
Mailing Address - Fax:
Practice Address - Street 1:5251 BARBER RD
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:NY
Practice Address - Zip Code:14784-9738
Practice Address - Country:US
Practice Address - Phone:716-595-3277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-01
Last Update Date:2014-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF306776-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health