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1902882038
MICHAEL TYSHKOV
STATEN ISLAND, NY
NPI
1902882038
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2080P0206X Pediatrics, Pediatric Gastroenterology
(Licence: NY 180877)
Enumeration Date
2005-12-20
Last Update Date
2008-12-31
Business Address
Dr. MICHAEL TYSHKOV MD
584 FOREST AVE
STATEN ISLAND, NY 10310-2512
Phone number: 718-226-5619
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Mailing Address
Dr. MICHAEL TYSHKOV MD
1 EDGEWATER ST 6TH FL. PAYER RELATIONS
STATEN ISLAND, NY 10305-4900
Phone number: 718-226-1008
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