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General NPI Number Information
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NPI Number | 1518169630
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Entity Type | Individual
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Provider Name | NATALIA POTAPOVA MD
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Gender | Female
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Dates
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Enumeration Date | 06/01/2007
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Last Update Date | 03/26/2013
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Provider Practice Location Address
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Address Line | 25 5TH AVE # 1A
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City | NEW YORK
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State | NY
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Zip | 10003-4307
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Country | US
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Telephone | 917-215-3687
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Fax | 917-591-0604
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Provider Business Mailing Address
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Address Line | 25 5TH AVE #1A
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City | NEW YORK
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State | NY
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Zip | 10003-4307
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Country | US
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Telephone | 917-215-3687
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Fax | 917-591-0604
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 255889
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License Number State | NY
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