Healthcare Provider Details

I. General information

NPI: 1629502372
Provider Name (Legal Business Name): RADMILA YOAV PA-C, MPAS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2017
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3448 NOSTRAND AVE
BROOKLYN NY
11229-5107
US

IV. Provider business mailing address

1455 GENEVA LOOP APT 7F
BROOKLYN NY
11239-2410
US

V. Phone/Fax

Practice location:
  • Phone: 347-756-3410
  • Fax: 646-517-3074
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number020761
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number020761
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: