Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204C00000X | Sports Medicine Doctor | 159570 | NY |
NPI | 1518019330 |
---|---|
Provider Name | Inna Lopatinsky |
First Address | Brooklyn, NY 11235-4812 |
Second Address | Brooklyn, NY 11235-4812 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00872344 | (05) | NY |
A63173 | (02) | NY |