MEDICARE: MISS YVONNE JEANNE ZILL PHYSICIAN ASSISTANT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA 9105929	NY

General Provider Information

NPI Number	:	1629369616
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS YVONNE JEANNE ZILL PHYSICIAN ASSISTANT

Provider Business Mailing Address
First Line	:	107 KIRKWOOD AVE
Second Line	:
City	:	MERRICK
State	:	NY
Zip	:	11566-4235
Country	:	US
Telephone Number	:	516-581-1551
Fax Number	:

Provider Business Practice Location Address
First Line	:	107 KIRKWOOD AVE
Second Line	:
City	:	MERRICK
State	:	NY
Zip	:	11566-4235
Country	:	US
Telephone Number	:	516-581-1551
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/25/2011
Last Update Date	:	02/10/2026

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