Active NPI
Tatyana Pukhovich
- Clinical Social Worker
- Kew Gardens, NY
National Provider Identifier
1033352802
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 070452-1
- Practice address
- 8002 Kew Gardens Rd
Kew Gardens, NY 11415-3600 - Phone
- (718) 793-2182
- Fax
- (718) 575-0839
- NPI assigned
- Apr 9, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 070452-1 | NY | Primary |
Addresses
Primary practice location
8002 Kew Gardens Rd
Kew Gardens, NY 11415-3600
Mailing address
2 Manor CT
New Hyde Park, NY 11040-2110
Phone (718) 793-2182
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070452-1 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1239235200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1239235200000",
"number": "1033352802",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 MANOR CT",
"city": "NEW HYDE PARK",
"state": "NY",
"postal_code": "110402110",
"telephone_number": "718-793-2182"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8002 KEW GARDENS RD",
"city": "KEW GARDENS",
"state": "NY",
"postal_code": "114153600",
"telephone_number": "718-793-2182",
"fax_number": "718-575-0839"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PUKHOVICH",
"first_name": "TATYANA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-04-09",
"last_updated": "2009-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "070452-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kew Gardens, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.