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Contact Information

IVGENIJA FASTOVSKY, MD
19111 COLLINS AVE APT 2505
SUNNY ISLES BEACH, FL33160-2384
 Phone: 305-933-6873
 Fax: 305-933-6873
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatric Psychiatry

2084P0805X 86 Physician/Neuropsychiatry
 

Psychiatry

2084P0800X 26 Physician/Psychiatry
Indicates primary specialty

NPI Profile & details for IVGENIJA FASTOVSKY · (Female)

NPI # 1043455645
Status Active
Credentials MD
Entity Individual
Enumeration date 12/10/2008
Last updated 12/10/2008 - About 17 years ago
Sole proprietor 1 Yes
Identifiers
  • FL License # ME 59109
  • NY Medicaid 00580525
  • NY Other P 55311 MEDICARE GHI
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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