Healthcare Provider Details

I. General information

NPI: 1821908880
Provider Name (Legal Business Name): EFE YENIGUN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

141 N CENTRAL AVE # 10603
HARTSDALE NY
10530-1987
US

IV. Provider business mailing address

845 N BROADWAY # 10601
WHITE PLAINS NY
10603-2403
US

V. Phone/Fax

Practice location:
  • Phone: 914-949-7699
  • Fax:
Mailing address:
  • Phone: 914-761-0600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: