National Provider Identifier

Andrey Takhtovich

Andrey Takhtovich is listed in the NPPES registry with a primary specialty of Family Medicine Physician in Elmira, NY and a listed phone number of (607) 795-8035.

NPI 1942707583Elmira, NYFamily Medicine Physician

Profile Overview

NPI
1942707583
Provider Type
Individual
Primary Specialty
Family Medicine Physician
Enumeration Date
April 10, 2018
Last Updated
September 07, 2021

Practice Location

  • 555 Saint Josephs Blvd
  • Elmira, NY 14901-3223

Phone: (607) 795-8035

Mailing Address

  • 92 Stonehurst Dr
  • Tenafly, NJ 07670-2917

Specialties

  • Family Medicine Physician (207Q00000X)
  • Student in an Organized Health Care Education/Training Program (390200000X)
Full Record
NPI
1942707583
Entity Type
Individual
Last Name
Takhtovich
First Name
Andrey
Mailing Street Address
92 Stonehurst Dr
Mailing City
Tenafly
Mailing State
NJ
Mailing ZIP Code
07670-2917
Mailing Country
US
Mailing Phone
(201) 227-8598
Practice Street Address
555 Saint Josephs Blvd
Practice City
Elmira
Practice State
NY
Practice ZIP Code
14901-3223
Practice Country
US
Practice Phone
(607) 795-8035
Enumeration Date
April 10, 2018
Last Updated
September 07, 2021
Sex
Male
Sole Proprietor
No
Certification Date
September 07, 2021
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Family Medicine Physician (207Q00000X), Student in an Organized Health Care Education/Training Program (390200000X)