Provider Demographics
NPI:1093137853
Name:YBREAST LLC
Entity Type:Organization
Organization Name:YBREAST LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:YADEGARI
Authorized Official - Suffix:
Authorized Official - Credentials:CLC, JD
Authorized Official - Phone:917-796-5501
Mailing Address - Street 1:60 HEATHER DR
Mailing Address - Street 2:
Mailing Address - City:ROSLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11576-2211
Mailing Address - Country:US
Mailing Address - Phone:917-796-5501
Mailing Address - Fax:516-456-0451
Practice Address - Street 1:60 HEATHER DR
Practice Address - Street 2:
Practice Address - City:ROSLYN
Practice Address - State:NY
Practice Address - Zip Code:11576-2211
Practice Address - Country:US
Practice Address - Phone:917-796-5501
Practice Address - Fax:516-456-0451
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-14
Last Update Date:2014-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Single Specialty