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General NPI Number Information
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NPI Number | 1972613768
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Entity Type | Individual
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Provider Name | YANA SHAMAEV BERK MD
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Gender | Female
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 06/17/2022
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Provider Practice Location Address
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Address Line | 200 WEST CARVER STREET
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City | HUNTINGTON
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State | NY
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Zip | 11743
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Country | US
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Telephone | 347-389-4945
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Fax | 631-421-5991
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Provider Business Mailing Address
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Address Line | 200 WEST CARVER STREET
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City | HUNTINGTON
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State | NY
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Zip | 11743
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Country | US
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Telephone | 347-389-4945
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Fax | 631-421-5991
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 192338-1
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License Number State | NY
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