Individual
KONSTANTIN YERETSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2800 MARCUS AVENUE, LAKE SUCCESS, NY 11042
(516) 622-7405
Mailing address
2800 MARCUS AVENUE, LAKE SUCCESS, NY 11042
(516) 622-7405
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
217992
NY
Other
Enumeration date
09/29/2006
Last updated
07/08/2007
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