Basic Information
| Provider Information | |||||||||
| NPI: | 1467795120 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | POKEZA | ||||||||
| FirstName: | NATALIYA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2880 OLD DIXWELL AVE | ||||||||
| Address2: | |||||||||
| City: | HAMDEN | ||||||||
| State: | CT | ||||||||
| PostalCode: | 065183144 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2032486365 | ||||||||
| FaxNumber: | 2032812742 | ||||||||
| Practice Location | |||||||||
| Address1: | 2880 OLD DIXWELL AVE | ||||||||
| Address2: | |||||||||
| City: | HAMDEN | ||||||||
| State: | CT | ||||||||
| PostalCode: | 065183144 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2032486365 | ||||||||
| FaxNumber: | 2032812742 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/01/2013 | ||||||||
| LastUpdateDate: | 11/03/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/03/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207W00000X | 62695 | CT | Y | Allopathic & Osteopathic Physicians | Ophthalmology |
No ID Information.