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General NPI Number Information
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NPI Number | 1962978510
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Entity Type | Individual
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Provider Name | YAILIN PINO PA-C
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Gender | Female
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Dates
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Enumeration Date | 10/22/2018
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Last Update Date | 10/06/2020
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Provider Practice Location Address
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Address Line | 4426 18TH AVE
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City | BROOKLYN
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State | NY
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Zip | 11204-1201
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Country | US
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Telephone | 718-635-9700
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Fax |
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Provider Business Mailing Address
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Address Line | 2922 NORTHERN BLVD APT 807
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City | LONG ISLAND CITY
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State | NY
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Zip | 11101-4085
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Country | US
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Telephone | 786-546-2243
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 024115
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License Number State | NY
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