MEDICARE: VIA NOVA INC

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
1	174400000X	Specialist

General Provider Information

NPI Number	:	1952257701
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VIA NOVA INC

Provider Business Mailing Address
First Line	:	92 DAWSON CIR FL 2
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10314-3825
Country	:	US
Telephone Number	:	347-217-6044
Fax Number	:

Provider Business Practice Location Address
First Line	:	92 DAWSON CIR FL 2
Second Line	:
City	:	STATEN ISLAND
State	:	NY
Zip	:	10314-3825
Country	:	US
Telephone Number	:	347-217-6044
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ELVIRA TIMASHEVA
Credential	:	MS
Telephone Number	:	347-217-6044

Provider Enumeration Date	:	03/05/2026
Last Update Date	:	03/18/2026

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Directions to “VIA NOVA INC ” Practice Location

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