Individual
YELENA YAKUTILOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
5321 FLATLANDS AVE, BROOKLYN, NY 11234-2322
(718) 517-2244
Mailing address
6333 ALDERTON ST, REGO PARK, NY 11374-2824
(917) 843-6436
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
024298
NY
207RP1001X
Pulmonary Disease Physician
Primary
024298
NY
207RS0012X
Sleep Medicine (Internal Medicine) Physician
024298
NY
Other
Enumeration date
09/22/2020
Last updated
09/22/2020
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