Otar Datiashvili
Medical Practice at Seaview Ave, Staten Island, NY

License number
Kentucky 48482
Issued Date
Sep 17, 2015
Expiration Date
Feb 29, 2016
Category
Emergency Medicine
Type
Hospital Based
Address
Address
475 Seaview Ave, Staten Island, NY 10305
Education
State University of New York at Stony Brook School of Medicine, 2012
Phone
(917) 655-6207 (Work)
LicenseFiles verified this license of Apr 21, 2017 at the Ky.gov - Commonwealth of Kentucky.

Medical Practice licenses in Kentucky