Healthcare Provider Details

I. General information

NPI: 1407933161
Provider Name (Legal Business Name): YAEL ROBSON-KUSHNER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 04/01/2021
Certification Date: 04/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20014 44TH AVE
BAYSIDE NY
11361-2510
US

IV. Provider business mailing address

20014 44TH AVE
BAYSIDE NY
11361-2510
US

V. Phone/Fax

Practice location:
  • Phone: 718-224-3000
  • Fax: 718-721-7237
Mailing address:
  • Phone: 718-224-3000
  • Fax: 718-224-6378

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number232691
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: