Antonevich, Ivan
Antonevich, Ivan is an individual health care provider with primary practice located at 1729 Burrstone Rd , New Hartford NY 13413-1001. He recently has only one registered license in Allopathic & Osteopathic Physicians / Interventional Pain Medicine, which is considered as his primary health care specialty. Antonevich, Ivan can be contacted via phone (315) 798-1567.Contact Information
Primary practice address
1729 Burrstone Rd
New Hartford NY 13413-1001
Phone: (315) 798-1567
Fax: (315) 798-1565
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Interventional Pain Medicine | 208VP0014X | 229252 | New York |
Profile Details
| NPI number | 1043256118 |
|---|---|
| LBN Legal business name | Antonevich, Ivan |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 20th, 2006 |
| Last updated | Jul 25th, 2016 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1043256118 | NPPES |
| Florida | MEDICAID | 2729598-00 |
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