Provider Demographics
NPI:1033576863
Name:RYZHAKOVA, YANA (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:DR
First Name:YANA
Middle Name:
Last Name:RYZHAKOVA
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4207 ATLANTIC AVE # 1B
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11224-1023
Mailing Address - Country:US
Mailing Address - Phone:646-696-1150
Mailing Address - Fax:
Practice Address - Street 1:2232 KIMBALL ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-5148
Practice Address - Country:US
Practice Address - Phone:718-684-4490
Practice Address - Fax:718-684-4498
Is Sole Proprietor?:No
Enumeration Date:2016-01-25
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY340277207K00000X, 207N00000X, 2084N0400X, 363LF0000X, 207QS1201X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No207N00000XAllopathic & Osteopathic PhysiciansDermatology
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No207QS1201XAllopathic & Osteopathic PhysiciansFamily MedicineSleep Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease