Individual provider · Type 1 NPI
Oded Haidatov, PA
Surgical Physician Assistant · Flushing, NY
NPI number
1144577925
Active
Practice location
14707A 77th Rd
Flushing, NY 11367-3428
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Surgical Physician Assistant Primary | 363AS0400X | 015869 (NY) |
Surgical Physician Assistant: Definition to come...
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About NPI 1144577925
Oded Haidatov, PA's National Provider Identifier is 1144577925, issued on Aug 10, 2012. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Flushing, NY. The record was last updated on Sep 13, 2012.