Healthcare Provider Details

I. General information

NPI: 1972804409
Provider Name (Legal Business Name): BARBARA BORISOVNA OGANIANTS P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/15/2010
Last Update Date: 11/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 W 51ST ST APARTMENT 1123
NEW YORK NY
10019-6836
US

IV. Provider business mailing address

150 W 51ST ST APARTMENT 1123
NEW YORK NY
10019-6836
US

V. Phone/Fax

Practice location:
  • Phone: 646-301-5893
  • Fax:
Mailing address:
  • Phone: 646-301-5893
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number028693
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: