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General NPI Number Information
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NPI Number | 1366790065
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Entity Type | Individual
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Provider Name | YULIYA SUNDATOVA RN, FNP
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Gender | Female
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Dates
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Enumeration Date | 08/28/2012
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Last Update Date | 06/10/2016
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Provider Practice Location Address
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Address Line | 325 WEST 15TH ST,ROOM C 47 BETH ISRAEL COMPREHENSIVE CANCER CENTERDEPT OF RADIATIO
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City | NEW YORK
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State | NY
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Zip | 10011
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Country | US
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Telephone | 212-367-1733
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Fax |
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Provider Business Mailing Address
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Address Line | RADIATION ONCOLOGY 10UNION SQUARE EAST
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City | NEW YORK
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State | NY
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Zip | 10003
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Country | US
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Telephone | 212-844-8089
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | F337446-1
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License Number State | NY
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