Healthcare Provider Details

I. General information

NPI: 1063342145
Provider Name (Legal Business Name): YULY TATIANA RUIZ PINILLA FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 HEMPSTEAD TPKE
EAST MEADOW NY
11554-1859
US

IV. Provider business mailing address

212 SAINT JOHNS PL
EAST MEADOW NY
11554-2421
US

V. Phone/Fax

Practice location:
  • Phone: 516-643-7072
  • Fax:
Mailing address:
  • Phone: 516-572-6703
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF359392
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: