Individual
DANIELLA YAKUBOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7502 186TH ST, FRESH MEADOWS, NY 11366-1722
(718) 223-0300
Mailing address
17625 UNION TPKE STE 370, FRESH MEADOWS, NY 11366-1515
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F351316-01
NY
Other
Enumeration date
02/14/2023
Last updated
02/14/2023
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