Provider Demographics
NPI:1093980104
Name:GORELIK, YULIYA (NNP)
Entity Type:Individual
Prefix:MRS
First Name:YULIYA
Middle Name:
Last Name:GORELIK
Suffix:
Gender:F
Credentials:NNP
Other - Prefix:MRS
Other - First Name:JULIA
Other - Middle Name:
Other - Last Name:GORELIK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NNP
Mailing Address - Street 1:34 HEARTHSTONE DR
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06804-3007
Mailing Address - Country:US
Mailing Address - Phone:203-775-9588
Mailing Address - Fax:
Practice Address - Street 1:WMC 95 GRASSLANDS RD
Practice Address - Street 2:NICU
Practice Address - City:VALHALLA
Practice Address - State:NY
Practice Address - Zip Code:10595
Practice Address - Country:US
Practice Address - Phone:914-493-7762
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY350286363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal