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General NPI Number Information
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NPI Number | 1386190510
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Entity Type | Individual
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Provider Name | TATYANA YELEVICH-IZNYUK MA, SP. ED., TSHH
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Gender | Female
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Dates
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Enumeration Date | 08/28/2016
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Last Update Date | 08/28/2016
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Provider Practice Location Address
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Address Line | 3215 COURT ST
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City | YORKTOWN HEIGHTS
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State | NY
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Zip | 10598-2503
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Country | US
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Telephone | 917-299-0969
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Fax |
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Provider Business Mailing Address
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Address Line | 3215 COURT STREET
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City | YORKTOWN HEIGHTS
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State | NY
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Zip | 10598
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Country | US
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Telephone | 917-299-0969
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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 | 174H00000X
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Taxonomy Name | Health Educator
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License Number | 394380031
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License Number State | NY
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