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NPI Code Detail

MEDICARE: KETHIA YUMUSAK

MEDICARE: KETHIA YUMUSAK
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse968393NY

General Provider Information

NPI Number : 1003791575
Entity Type Code : Individual
Provider Name (Legal Business Name) : KETHIA YUMUSAK
Provider Business Mailing Address
First Line : 75 NEW SCOTLAND AVE
Second Line :
City : ALBANY
State : NY
Zip : 12208-3409
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 75 NEW SCOTLAND AVE
Second Line :
City : ALBANY
State : NY
Zip : 12208-3409
Country : US
Telephone Number : 518-549-6611
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/06/2025
Last Update Date : 12/19/2025

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Directions to “ KETHIA YUMUSAK ” Practice Location

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