Nonna Datiashvili


Address: 227 Koch Blvd, Staten Island, NY 10312-5416
Phone: 7186057000

Nonna Datiashvili (NPI# 1326032673, PAC ID# 3779685540) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.

Physician Overview

Nation Provider ID (NPI) 1326032673
PAC ID by PECOS 3779685540
Professional Enrollment ID I20070226000147
Full Name Nonna Datiashvili
Address 227 Koch Blvd
Staten Island
NY 10312-5416
Phone Number 7186057000
Gender F
Credential MD
Graduation Year 1989
Primary Specialty INTERNAL MEDICINE
Accepts Medicare Assignment Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
330160 STATEN ISLAND UNIVERSITY HOSPITAL

Other Locations

Address Phone Organization
227 Koch Blvd, Staten Island, NY 10312-5416 7186057000

Organization Information

Office Location

Street Address 227 KOCH BLVD
City STATEN ISLAND
State NY
Zip 10312-5416

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Alla Zlotina Optometry 273 Eltingville Blvd, Staten Island, NY 10312-2447
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Competitor

Search similar physicians

City STATEN ISLAND
Zip Code 10312
Specialty INTERNAL MEDICINE
City + Specialty STATEN ISLAND + INTERNAL MEDICINE

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS)
Jurisdiction Medicare

This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.

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