Healthcare Provider Details

I. General information

NPI: 1437209079
Provider Name (Legal Business Name): ZINAIDA YEL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/12/2007
Last Update Date: 05/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

OLMMC, MENTAL HEALTH CLINIC 4401 BRONX BOULEVARD
BRONX NY
10470
US

IV. Provider business mailing address

3411 IRWIN AVE APT. #16F
BRONX NY
10463-3732
US

V. Phone/Fax

Practice location:
  • Phone: 718-304-7011
  • Fax: 718-920-9217
Mailing address:
  • Phone: 718-769-4805
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number225104
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: