Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 024463 | NY |
NPI | 1063057347 |
---|---|
Provider Name | Viorika Chebotaru |
First Address | Brooklyn, NY 11235-1606 |
Second Address | Brooklyn, NY 11224-3602 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/11/2019 |
Last Update Date | 09/07/2020 |