Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 262250 | NY |
Y | 111NI0900X | Internist | 262250 | NY |
N | 207RG0300X | Geriatric Medicine | 262250 | NY |
NPI | 1033359757 |
---|---|
Provider Name | Dr. Tina Urpanishvili |
First Address | New York, NY 10003-9001 |
Second Address | New York, NY 10003-9001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2009 |
Last Update Date | 11/04/2017 |