Provider Demographics
NPI:1982249868
Name:ROYTMAN, TETYANA (FNP)
Entity Type:Individual
Prefix:
First Name:TETYANA
Middle Name:
Last Name:ROYTMAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:TETYANA
Other - Middle Name:
Other - Last Name:PAVLYUH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:1117 BRIGHTON BEACH AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235
Mailing Address - Country:US
Mailing Address - Phone:718-998-9900
Mailing Address - Fax:
Practice Address - Street 1:1117 BRIGHTON BEACH AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235
Practice Address - Country:US
Practice Address - Phone:718-998-9900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-14
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY345241363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily