Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0204X | Pediatric Emergency Doctor | 234012-1 | NY |
NPI | 1235150558 |
---|---|
Provider Name | Yelena Bataykin |
First Address | Brooklyn, NY 11229-3944 |
Second Address | Brooklyn, NY 11235-7745 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02681143 | (05) | NY |
I28103 | (02) | NY |