Healthcare Provider Details

I. General information

NPI: 1104788389
Provider Name (Legal Business Name): YAZMIN ALONDRA COYOMANI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/26/2025
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1430 BROADWAY
ASTORIA NY
11106-4530
US

IV. Provider business mailing address

8823 JUSTICE AVE FL 3
ELMHURST NY
11373-4558
US

V. Phone/Fax

Practice location:
  • Phone: 347-531-4132
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number133462
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: