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
—
—
Other
Enumeration date
01/12/2021
Last updated
01/12/2021
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