Provider Demographics
NPI:1225296510
Name:YATSENKO, NATALIYA (MD)
Entity Type:Individual
Prefix:DR
First Name:NATALIYA
Middle Name:
Last Name:YATSENKO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5617 RAMSEY ST
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28311-1423
Mailing Address - Country:US
Mailing Address - Phone:910-483-7337
Mailing Address - Fax:910-483-0648
Practice Address - Street 1:609 ATTAIN ST
Practice Address - Street 2:SUITE 181
Practice Address - City:FUQUAY VARINA
Practice Address - State:NC
Practice Address - Zip Code:27526-1979
Practice Address - Country:US
Practice Address - Phone:919-557-5433
Practice Address - Fax:919-557-6279
Is Sole Proprietor?:No
Enumeration Date:2008-05-23
Last Update Date:2016-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2009-01709208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC19M1POtherBLUE CROSS BLUE SHIELD OF NORTH CAROLINA
NC6217977OtherUNITED HEALTHCARE
NC4866147OtherAETNA-PRONET