Provider Demographics
NPI:1750324117
Name:NATOVICH, NATALIA (MD)
Entity type:Individual
Prefix:
First Name:NATALIA
Middle Name:
Last Name:NATOVICH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NATALIA
Other - Middle Name:
Other - Last Name:ARTIOUKHINA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:440 EAST 9TH STREET
Mailing Address - Street 2:APT 4A
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218
Mailing Address - Country:US
Mailing Address - Phone:718-693-2157
Mailing Address - Fax:
Practice Address - Street 1:3049 OCEAN PKWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-8372
Practice Address - Country:US
Practice Address - Phone:718-775-7733
Practice Address - Fax:347-702-7551
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY234971207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02729940Medicaid
NY451AXMW401Medicare PIN