Provider Demographics
NPI:1144235813
Name:YLAND, KATHRYNNE F (MD)
Entity Type:Individual
Prefix:
First Name:KATHRYNNE
Middle Name:F
Last Name:YLAND
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 1:241 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-2924
Mailing Address - Country:US
Mailing Address - Phone:631-367-5300
Mailing Address - Fax:631-351-4561
Practice Address - Street 1:241 E MAIN ST
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-2924
Practice Address - Country:US
Practice Address - Phone:631-367-5300
Practice Address - Fax:631-351-4561
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY205010-12080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2C4840OtherHEALTHNET
NYP845167OtherOXFORD
NY01886460Medicaid
NY18X411OtherBLUE CROSS/ BLUE SHIELD
NY2698163OtherGHI
NY18X411Medicare ID - Type Unspecified
NY18X411OtherBLUE CROSS/ BLUE SHIELD