Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 216515 | NY |
NPI | 1558575514 |
---|---|
Provider Name | Tatiana Voitovitch-Khurgin |
First Address | New York, NY 10024-2904 |
Second Address | Brooklyn, NY 11201 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02092322 | (05) | NY |
216515 | LICENSE (01) | NY |
BV6802931 | DEA (01) | NY |
H20247 | (02) | NY |