Novofastovsky, Raisa

Novofastovsky, Raisa is an sole proprietor health care provider with primary practice located at 1812 Quentin Rd Suite M-2, Brooklyn NY 11229-1336. She recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as her primary health care specialty. Novofastovsky, Raisa can be contacted via phone (718) 382-1773.

Contact Information

Primary practice address
1812 Quentin Rd Suite M-2 Brooklyn NY 11229-1336
Phone: (718) 382-1773
Fax: (718) 382-3214
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X N 004903 New York

Profile Details

NPI number 1710950878
LBN Legal business name Novofastovsky, Raisa
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 9th, 2006
Last updated Aug 19th, 2013 - about 11 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710950878 NPPES
New York MEDICAID 01250811
New York Other P3603491
New York Other 214483P

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