Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | OS13270 | FL |
N | 207ND0900X | Dermatopathologist | 34.011030 | OH |
N | 207ND0900X | Dermatopathologist | OS13270 | FL |
NPI | 1114242039 |
---|---|
Provider Name | Dr. Ivanka Kovalyshyn |
First Address | West Palm Beach, FL 33409-1997 |
Second Address | West Palm Beach, FL 33409-1997 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2010 |
Last Update Date | 28/04/2017 |