Healthcare Provider Details
I. General information
NPI: 1396732095
Provider Name (Legal Business Name): NINA ARLIEVSKY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/29/2005
Last Update Date: 07/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
19 BRADHURST AVE SUITE 1400
HAWTHORNE NY
10532-2140
US
IV. Provider business mailing address
22 SAW MILL RIVER RD 2ND FLOOR
HAWTHORNE NY
10532-1533
US
V. Phone/Fax
- Phone: 914-493-8333
- Fax: 914-594-4366
- Phone: 914-493-8333
- Fax: 914-594-4366
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080P0208X |
| Taxonomy | Pediatric Infectious Diseases Physician |
| License Number | 183621 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: