Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 049522 | NY |
Y | 213EG0000X | General Practice | 049522 | NY |
NPI | 1003022997 |
---|---|
Provider Name | Dr. Yanina Krayevsky |
First Address | Long Beach, NY 11561-3834 |
Second Address | Merrick, NY 11566-3463 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2007 |
Last Update Date | 08/07/2007 |