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General NPI Number Information
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NPI Number | 1346604568
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Entity Type | Individual
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Provider Name | YULIYA SHAULOVA R. N.
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Gender | Female
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Dates
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Enumeration Date | 04/13/2016
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Last Update Date | 04/13/2016
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Provider Practice Location Address
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Address Line | 9131 QUEENS BLVD SUITE 604
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City | ELMHURST
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State | NY
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Zip | 11373-5555
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Country | US
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Telephone | 718-779-7000
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Fax |
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Provider Business Mailing Address
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Address Line | 14747 78TH RD
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City | FLUSHING
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State | NY
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Zip | 11367-3535
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Country | US
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Telephone | 718-969-2474
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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 | 163WC1500X
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Taxonomy Name | Community Health Registered Nurse
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License Number | 586532
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License Number State | NY
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