Healthcare Provider Details

I. General information

NPI: 1982977302
Provider Name (Legal Business Name): VALENTINA PAVLOTSKY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/15/2012
Last Update Date: 02/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2928 W 36TH ST
BROOKLYN NY
11224-1410
US

IV. Provider business mailing address

2928 W 36TH ST
BROOKLYN NY
11224-1410
US

V. Phone/Fax

Practice location:
  • Phone: 718-372-3300
  • Fax: 718-996-8758
Mailing address:
  • Phone: 718-372-3300
  • Fax: 718-996-8758

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: