Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 25MA08029700 | NJ |
NPI | 1023041100 |
---|---|
Provider Name | Natalia Y Rezvina |
First Address | Voorhees, NJ 08043-0536 |
Second Address | Somers Point, NJ 08244-1846 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2006 |
Last Update Date | 03/03/2020 |