Provider Demographics
NPI:1093597536
Name:BALTAR, YUVELIN
Entity Type:Individual
Prefix:DR
First Name:YUVELIN
Middle Name:
Last Name:BALTAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:189 MELANIE DR
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-1436
Mailing Address - Country:US
Mailing Address - Phone:646-468-2191
Mailing Address - Fax:
Practice Address - Street 1:189 MELANIE DR
Practice Address - Street 2:
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-1436
Practice Address - Country:US
Practice Address - Phone:646-468-2191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-18
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017610103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist