Provider Demographics
NPI:1225469331
Name:GITELMAN, MAYYA K (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MRS
First Name:MAYYA
Middle Name:K
Last Name:GITELMAN
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:3101 OCEAN PKWY
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-8440
Mailing Address - Country:US
Mailing Address - Phone:718-946-2481
Mailing Address - Fax:718-266-5346
Practice Address - Street 1:3101 OCEAN PKWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-8440
Practice Address - Country:US
Practice Address - Phone:718-946-2481
Practice Address - Fax:718-266-5346
Is Sole Proprietor?:No
Enumeration Date:2013-11-29
Last Update Date:2013-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF337433-1364SF0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health