# WILLIAMSBURG MEDICAL OF NEW YORK LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1740100858
- **Authorized official:** DR. YAN KATSNELSON (CEO)
- **Authorized official phone:** (847) 774-5300

## Contact information

- **Practice address:** 1229 BROADWAY STE 103, HEWLETT, NY 11557-2014
- **Practice address phone:** (847) 257-1244
- **Mailing address:** PO BOX 32, NORTHBROOK, IL 60065-0032

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | NULL | Yes |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | — | Yes |
| 2086S0129X | Vascular Surgery Physician | — | NULL | — |
| 2086S0129X | Vascular Surgery Physician | — | — | — |

## Other

- **Enumeration date:** 07/18/2026
- **Last updated:** 07/24/2026