Provider Demographics
NPI:1316254410
Name:DIREKTOR, SVETLANA (RN, NP)
Entity type:Individual
Prefix:
First Name:SVETLANA
Middle Name:
Last Name:DIREKTOR
Suffix:
Gender:F
Credentials:RN, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 PENN PLZ
Mailing Address - Street 2:#1201
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-1810
Mailing Address - Country:US
Mailing Address - Phone:347-804-4910
Mailing Address - Fax:212-290-3933
Practice Address - Street 1:5 PENN PLZ
Practice Address - Street 2:# 1201
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-1810
Practice Address - Country:US
Practice Address - Phone:212-609-1920
Practice Address - Fax:212-290-3933
Is Sole Proprietor?:No
Enumeration Date:2010-09-10
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY335972363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily