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General NPI Number Information
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NPI Number | 1295097871
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Entity Type | Individual
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Provider Name | JESSICA YAMPOLSKY
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Gender | Female
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Dates
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Enumeration Date | 06/11/2012
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Last Update Date | 06/11/2012
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Provider Practice Location Address
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Address Line | 1565 E 14TH ST APT 3H
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City | BROOKLYN
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State | NY
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Zip | 11230-7162
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Country | US
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Telephone | 917-676-9671
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Fax |
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Provider Business Mailing Address
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Address Line | 1565 EAST 14TH ST APT 3H
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City | BROOKLYN
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State | NY
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Zip | 11230
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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