Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | F421434 | NY |
NPI | 1013529692 |
---|---|
Provider Name | Angelina Yushuvayev |
First Address | Flushing, NY 11367-3428 |
Second Address | Flushing, NY 11367-3428 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2020 |
Last Update Date | 17/08/2020 |