Provider Demographics
NPI:1457325771
Name:ROYTMAN, YULIYA (OD)
Entity Type:Individual
Prefix:
First Name:YULIYA
Middle Name:
Last Name:ROYTMAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 DOVER ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-3722
Mailing Address - Country:US
Mailing Address - Phone:917-660-4513
Mailing Address - Fax:
Practice Address - Street 1:3511 QUENTIN RD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-3722
Practice Address - Country:US
Practice Address - Phone:917-660-4513
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV 006805152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV01914Medicare UPIN
NYC351F1Medicare PIN