Healthcare Provider Details
I. General information
NPI: 1255143194
Provider Name (Legal Business Name): YAVNEAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/27/2025
Last Update Date: 07/02/2025
Certification Date: 07/02/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
80 MAIN ST
BLOOMINGBURG NY
12721-4638
US
IV. Provider business mailing address
80 MAIN ST
BLOOMINGBURG NY
12721-4638
US
V. Phone/Fax
- Phone: --
- Fax:
- Phone: 347-889-1254
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MORDECHAT
SCHWEID
Title or Position: OWNER
Credential:
Phone: --