Provider Demographics
NPI:1497007041
Name:NUNEZ, YASMIN (PA)
Entity Type:Individual
Prefix:
First Name:YASMIN
Middle Name:
Last Name:NUNEZ
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542-2015
Mailing Address - Country:US
Mailing Address - Phone:516-676-2904
Mailing Address - Fax:516-268-9477
Practice Address - Street 1:104 FOREST AVE
Practice Address - Street 2:
Practice Address - City:GLEN COVE
Practice Address - State:NY
Practice Address - Zip Code:11542-2015
Practice Address - Country:US
Practice Address - Phone:516-676-2904
Practice Address - Fax:516-268-9477
Is Sole Proprietor?:No
Enumeration Date:2012-10-05
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical