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NPI Code Detail

MEDICARE: MRS. TATYANA INGBERMAN M.D.

MEDICARE: MRS. TATYANA INGBERMAN M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician200551NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1962407106
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TATYANA INGBERMAN M.D.
Provider Business Mailing Address
First Line : 749 OCEAN PKWY
Second Line :
City : BROOKLYN
State : NY
Zip : 11230-7813
Country : US
Telephone Number : 718-724-0900
Fax Number : 718-724-1590
Provider Business Practice Location Address
First Line : 749 OCEAN PKWY
Second Line :
City : BROOKLYN
State : NY
Zip : 11230-7813
Country : US
Telephone Number : 718-724-0900
Fax Number : 718-724-1590
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2005
Last Update Date : 11/13/2007

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