Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | F307917-1 | NY |
NPI | 1023598166 |
---|---|
Provider Name | Vladimir Tarnopolskiy |
First Address | New York, NY 10021-4823 |
Second Address | New York, NY 10021-4823 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2018 |
Last Update Date | 30/08/2020 |