Provider Demographics
NPI:1326592056
Name:URENA, YOKASTA (MSED, TVI)
Entity Type:Individual
Prefix:MISS
First Name:YOKASTA
Middle Name:
Last Name:URENA
Suffix:
Gender:F
Credentials:MSED, TVI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13840 68TH DR
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-1633
Mailing Address - Country:US
Mailing Address - Phone:646-509-0235
Mailing Address - Fax:
Practice Address - Street 1:13840 68TH DR
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-1633
Practice Address - Country:US
Practice Address - Phone:646-509-0235
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-10
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY882502141174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist