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Organization
EA NURSE PRACTITIONER IN ADULT HEALTH PC
Active
Organization
EA NURSE PRACTITIONER IN ADULT HEALTH PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. OLGA YUSHUVAYEVA NP-C (CEO)
(718) 288-6075
Entity
Organization
Contact information
Practice address
228 GREENWAY RD, LIDO BEACH, NY 11561-4829
(718) 288-6075
Mailing address
228 GREENWAY RD, LIDO BEACH, NY 11561-4829
(718) 288-6075
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
—
NULL
363LA2200X
Adult Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/12/2021
Last updated
01/12/2021
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