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NPI Code Detail

MEDICARE: TATYANA TAYTS NURSE PRACTITIONER

MEDICARE: TATYANA TAYTS NURSE PRACTITIONER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LA2200XAdult Health Nurse PractitionerF309079NY

General Provider Information

NPI Number : 1861057358
Entity Type Code : Individual
Provider Name (Legal Business Name) : TATYANA TAYTS NURSE PRACTITIONER
Provider Business Mailing Address
First Line : 933 W FINGERBOARD RD
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10304-4413
Country : US
Telephone Number : 917-650-4035
Fax Number :
Provider Business Practice Location Address
First Line : 2301 QUEENS PLZ N
Second Line :
City : LONG ISLAND CITY
State : NY
Zip : 11101
Country : US
Telephone Number : 718-433-9500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2019
Last Update Date : 05/09/2019

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Directions to “ TATYANA TAYTS NURSE PRACTITIONER” Practice Location

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