Provider Demographics
NPI:1467137133
Name:KUCHYNSKA, YANA (OD)
Entity Type:Individual
Prefix:
First Name:YANA
Middle Name:
Last Name:KUCHYNSKA
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 1:8320 SILVER FOX RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40291-2671
Mailing Address - Country:US
Mailing Address - Phone:347-884-7497
Mailing Address - Fax:
Practice Address - Street 1:3618 MALL RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40218-5403
Practice Address - Country:US
Practice Address - Phone:502-855-5800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-20
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2331DT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist