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General NPI Number Information
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NPI Number | 1427416189
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Entity Type | Organization
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Legal Business Name | PRN PC
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Dates
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Enumeration Date | 02/09/2016
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Last Update Date | 12/12/2024
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Provider Practice Location Address
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Address Line | 4050 NOSTRAND AVE STE 1M
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City | BROOKLYN
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State | NY
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Zip | 11235-2250
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Country | US
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Telephone | 347-450-6040
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Fax | 201-221-8073
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Provider Business Mailing Address
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Address Line | 2355 E 12TH ST APT 2G
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City | BROOKLYN
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State | NY
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Zip | 11229-4224
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Country | US
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Telephone | 646-696-1150
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. YANA RYZHAKOVA
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Credential |
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Telephone | 347-450-6040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 340277
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License Number State | NY
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