Provider Demographics
NPI:1558115204
Name:YAHORAVA, HALINA (FNP-C)
Entity Type:Individual
Prefix:
First Name:HALINA
Middle Name:
Last Name:YAHORAVA
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 VREELAND PL
Mailing Address - Street 2:
Mailing Address - City:ALLENDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07401-1525
Mailing Address - Country:US
Mailing Address - Phone:201-264-5388
Mailing Address - Fax:
Practice Address - Street 1:22 VREELAND PL
Practice Address - Street 2:
Practice Address - City:ALLENDALE
Practice Address - State:NJ
Practice Address - Zip Code:07401-1525
Practice Address - Country:US
Practice Address - Phone:201-264-5388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-17
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ14959600207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine