Individual
YAKOV DUDELZAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2615 E 16TH ST, 2ND FLOOR, BROOKLYN, NY 11235-3805
(718) 263-0300
Mailing address
567 DONALD LN, WOODMERE, NY 11598-1516
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
243425
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02870744
—
NY
01
—
560311
MEDICARE
—
Enumeration date
04/03/2007
Last updated
11/07/2007
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