Provider Demographics
NPI:1740539931
Name:KRIVITSKAYA, NATALIYA (MD)
Entity type:Individual
Prefix:DR
First Name:NATALIYA
Middle Name:
Last Name:KRIVITSKAYA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:627 LYDIG AVE
Mailing Address - Street 2:1 FL
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-2283
Mailing Address - Country:US
Mailing Address - Phone:718-772-0070
Mailing Address - Fax:
Practice Address - Street 1:627 LYDIG AVE
Practice Address - Street 2:1 FL
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10462-2283
Practice Address - Country:US
Practice Address - Phone:718-772-0070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-03
Last Update Date:2013-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT051255208000000X
NY267198208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics