Basic Information
Provider Information
NPI: 1730309246
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: APOLLONSKY
FirstName: NATALY
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3601 A ST
Address2:  
City: PHILADELPHIA
State: PA
PostalCode: 191341043
CountryCode: US
TelephoneNumber: 2154275000
FaxNumber:  
Practice Location
Address1: 3601 A ST
Address2:  
City: PHILADELPHIA
State: PA
PostalCode: 191341043
CountryCode: US
TelephoneNumber: 2154275000
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/26/2007
LastUpdateDate: 03/13/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2080P0207X440184PAY Allopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology

No ID Information.


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