Provider Demographics
NPI:1487604518
Name:KRICHMAR, NATALYA (MD)
Entity type:Individual
Prefix:
First Name:NATALYA
Middle Name:
Last Name:KRICHMAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 SADDLE LN
Mailing Address - Street 2:
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-4428
Mailing Address - Country:US
Mailing Address - Phone:917-573-5668
Mailing Address - Fax:516-802-3970
Practice Address - Street 1:200 BOUNDARY AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-1152
Practice Address - Country:US
Practice Address - Phone:516-755-2404
Practice Address - Fax:516-755-2405
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-11
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY232567207R00000X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY6Z4721Medicare ID - Type Unspecified
NYI52314Medicare UPIN