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General NPI Number Information
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NPI Number | 1316932015
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Entity Type | Individual
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Provider Name | SVETLANA B TEN MD
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Gender | Female
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Dates
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Enumeration Date | 09/19/2005
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Last Update Date | 01/08/2020
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Provider Practice Location Address
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Address Line | 2691 HYLAN BLVD SUITE D
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City | STATEN ISLAND
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State | NY
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Zip | 10306-4357
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Country | US
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Telephone | 718-228-8500
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Fax | 718-228-8500
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Provider Business Mailing Address
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Address Line | 77 WHITMAN AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10308-3226
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Country | US
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Telephone | 718-228-8500
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Fax | 718-228-8500
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0205X
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Taxonomy Name | Pediatric Endocrinology Physician
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License Number | 239969
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License Number State | NY
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