Healthcare Provider Details

I. General information

NPI: 1841899051
Provider Name (Legal Business Name): MARIYA YANOVSKAYA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2020
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 BUCK CREEK RD STE 200
AVON CO
81620-5428
US

IV. Provider business mailing address

50 BUCK CREEK RD STE 200
AVON CO
81620-5428
US

V. Phone/Fax

Practice location:
  • Phone: 970-926-6340
  • Fax:
Mailing address:
  • Phone: 970-926-6340
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License NumberDR.0078139
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: