Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 350286 | NY |
NPI | 1093980104 |
---|---|
Provider Name | Mrs. Yuliya Gorelik |
First Address | Brookfield, CT 06804-3007 |
Second Address | Valhalla, NY 10595 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/04/2008 |
Last Update Date | 29/04/2008 |