Provider Demographics
NPI:1427185297
Name:RIVKIN, YULIYA (RPA-C)
Entity Type:Individual
Prefix:MRS
First Name:YULIYA
Middle Name:
Last Name:RIVKIN
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:388 S PLEASANT AVE
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-5443
Mailing Address - Country:US
Mailing Address - Phone:718-680-9421
Mailing Address - Fax:
Practice Address - Street 1:462 1ST AVE
Practice Address - Street 2:BELLEVUE HOSPITAL, CARDIOTHORACIC SURGERY DEP-T, 10S-1
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-9196
Practice Address - Country:US
Practice Address - Phone:212-562-2227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007590363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant