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General NPI Number Information
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NPI Number | 1891424644
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Entity Type | Organization
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Legal Business Name | PTASHINSKY MEDICAL
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Dates
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Enumeration Date | 06/07/2022
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Last Update Date | 03/06/2025
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Provider Practice Location Address
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Address Line | 54910 N CIRCLE DRIVE
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City | IDYLLWILD
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State | CA
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Zip | 92549
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Country | US
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Telephone | 917-225-6302
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 786
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City | IDYLLWILD
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State | CA
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Zip | 92549-0786
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Country | US
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Telephone | 917-225-6302
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | NATALYA PTASHINSKY
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Credential | A/GNP
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Telephone | 917-225-6302
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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