Healthcare Provider Details

I. General information

NPI: 1487649901
Provider Name (Legal Business Name): YULIYA MILSHTEYN CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: YULIYA GROYZBURG CNM

II. Dates (important events)

Enumeration Date: 09/12/2005
Last Update Date: 10/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2183 OCEAN AVE
BROOKLYN NY
11229-2303
US

IV. Provider business mailing address

713 AVENUE Y
BROOKLYN NY
11235-6126
US

V. Phone/Fax

Practice location:
  • Phone: 718-376-6655
  • Fax:
Mailing address:
  • Phone: 718-648-7141
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberF420657
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberF001079-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: