MEDICARE: OKSANA YOVCHENKO RN

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
1	163W00000X	Registered Nurse	706141	NY
2	363LA2200X	Adult Health Nurse Practitioner	311458	NY

General Provider Information

NPI Number	:	1508464264
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OKSANA YOVCHENKO RN

Provider Business Mailing Address
First Line	:	6295 SAUNDERS ST APT 4N
Second Line	:
City	:	REGO PARK
State	:	NY
Zip	:	11374-1573
Country	:	US
Telephone Number	:	347-998-5988
Fax Number	:

Provider Business Practice Location Address
First Line	:	1811 HONE AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10461-1406
Country	:	US
Telephone Number	:	516-499-9016
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/15/2020
Last Update Date	:	12/09/2023

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