Provider Demographics
NPI:1508262866
Name:MUSHEYEV, YANA
Entity Type:Individual
Prefix:
First Name:YANA
Middle Name:
Last Name:MUSHEYEV
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10408 ROOSEVELT AVE
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:NY
Mailing Address - Zip Code:11368-2328
Mailing Address - Country:US
Mailing Address - Phone:718-426-6500
Mailing Address - Fax:718-426-6501
Practice Address - Street 1:2610 NE 213TH ST UNIT 103
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33180-1139
Practice Address - Country:US
Practice Address - Phone:917-562-6702
Practice Address - Fax:917-554-6065
Is Sole Proprietor?:No
Enumeration Date:2014-11-14
Last Update Date:2019-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT17514225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist