Healthcare Provider Details

I. General information

NPI: 1184759177
Provider Name (Legal Business Name): YELENA SHVETS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 11/03/2023
Certification Date: 11/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 PARK AVE OCCUPATIONAL HEALTH SERVICE
NEW YORK NY
10016-3702
US

IV. Provider business mailing address

7025 AVENUE N
BROOKLYN NY
11234-5715
US

V. Phone/Fax

Practice location:
  • Phone: 212-563-5020
  • Fax:
Mailing address:
  • Phone: 917-405-8298
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number335009
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number404444
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: