Healthcare Provider Details

I. General information

NPI: 1629574165
Provider Name (Legal Business Name): DR. IGOR KATSYV
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2018
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

533 W 57TH ST FL 6
NEW YORK NY
10019-2923
US

IV. Provider business mailing address

533 W 57TH ST FL 6
NEW YORK NY
10019-2923
US

V. Phone/Fax

Practice location:
  • Phone: 212-241-9728
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZD0900X
TaxonomyDermatopathology (Pathology) Physician
License Number308578
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: