Dr. Rafael Yakutilov
Neurologist
15 Beach 105th St
Rockaway Park
, New York 11694-2640
Dr. Rafael Yakutilov
Neurologist
15 Beach 105th St
Rockaway Park
, New York 11694-2640
(718) 474-2033
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About
Features
Specialties
- Neurologist
Languages spoken
- English
Location
First Address
- Dr. Rafael Yakutilov
- 15 Beach 105th St
- Rockaway Park, NY
- Zip : 11694-2640
- Fax : (718) 474-2033
- Phone : (718) 474-0023
Second Address
- Dr. Rafael Yakutilov
- 15 Beach 105th St
- Rockaway Park, NY
- Zip : 11694-2640
- Fax : (718) 474-2033
- Phone : (718) 474-0023
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2084N0400X | Neurologist | 229375 | NY |
National Provider Identifier
| NPI | 1003811720 |
|---|---|
| Provider Name | Dr. Rafael Yakutilov |
| First Address | Rockaway Park, NY 11694-2640 |
| Second Address | Rockaway Park, NY 11694-2640 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 17/06/2005 |
| Last Update Date | 30/01/2009 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 02574349 | (05) | NY |
| I04230 | (02) | NY |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.