Provider Demographics
NPI:1235894759
Name:SHTAPEL, YANA
Entity Type:Individual
Prefix:DR
First Name:YANA
Middle Name:
Last Name:SHTAPEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1745 E 18TH ST APT 5C
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-2116
Mailing Address - Country:US
Mailing Address - Phone:917-691-6226
Mailing Address - Fax:
Practice Address - Street 1:1745 E 18TH ST APT 5C
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-2116
Practice Address - Country:US
Practice Address - Phone:917-691-6226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-01
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY068225183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist