Provider Demographics
NPI:1114965019
Name:TIMASHPOLSKY, YULYA (MD)
Entity Type:Individual
Prefix:
First Name:YULYA
Middle Name:
Last Name:TIMASHPOLSKY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 MADISON AVE FL 5
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-1600
Mailing Address - Country:US
Mailing Address - Phone:212-545-2400
Mailing Address - Fax:646-312-0481
Practice Address - Street 1:4215 3RD AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-4501
Practice Address - Country:US
Practice Address - Phone:718-294-5891
Practice Address - Fax:718-294-2468
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2015-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA80340207R00000X
NY247050207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA20994OtherBCBSRI
MA771708OtherTUFTS HEALTH
MA36686OtherCHILDREN'S MEDICAL SEC
MA66185OtherHARVARD PILGRIM
MA0002592OtherNEIGHBORHOOD HEALTH PLAN
MDB10436301OtherCIGNA
MA110228103OtherRAILROAD MEDICARE
MA964303-01OtherNETWORK HEALTH
NY00695941Medicaid
MA0401906OtherUNITED HEALTH
MA042675800OtherHUMANA
MA2120544OtherAETNA
MAJ31322OtherBCBSMA
MA004436OtherSENIOR WHOLE HEALTH
MA406113OtherBCBSRIBLUECHIP
MA000000024045OtherBMC HEALTHNET
MA3144445Medicaid
MA5326938-002OtherCIGNA PAL
MA66185OtherHARVARD PILGRIM
MA3144445Medicaid
NYG100000410Medicare Oscar/Certification
NY331952Medicare Oscar/Certification
NY331043Medicare Oscar/Certification
NY331944Medicare Oscar/Certification
MAJ31322OtherBCBSMA
MA5326938-002OtherCIGNA PAL
MA004436OtherSENIOR WHOLE HEALTH
NY00695941Medicaid
NY331945Medicare Oscar/Certification
NY331058Medicare Oscar/Certification
NY331946Medicare Oscar/Certification
MA20994OtherBCBSRI
NY331943Medicare Oscar/Certification