Provider Demographics
NPI:1437209079
Name:YEL, ZINAIDA (MD)
Entity Type:Individual
Prefix:
First Name:ZINAIDA
Middle Name:
Last Name:YEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3411 IRWIN AVE
Mailing Address - Street 2:APT. #16F
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-3732
Mailing Address - Country:US
Mailing Address - Phone:718-769-4805
Mailing Address - Fax:
Practice Address - Street 1:OLMMC, MENTAL HEALTH CLINIC
Practice Address - Street 2:4401 BRONX BOULEVARD
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10470
Practice Address - Country:US
Practice Address - Phone:718-304-7011
Practice Address - Fax:718-920-9217
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2011-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2251042084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYOLM-00243563Medicaid
NYOLM-330072Medicare ID - Type Unspecified
NYOLM-00243563Medicaid