Provider Demographics
NPI:1568448132
Name:VINOKUROVA, YULIYA (MD)
Entity Type:Individual
Prefix:DR
First Name:YULIYA
Middle Name:
Last Name:VINOKUROVA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 OCEANA DR E # 3B
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-6695
Mailing Address - Country:US
Mailing Address - Phone:718-375-6500
Mailing Address - Fax:718-375-3667
Practice Address - Street 1:1928 BAY AVE STE 100200
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-6214
Practice Address - Country:US
Practice Address - Phone:718-375-6500
Practice Address - Fax:718-375-3667
Is Sole Proprietor?:No
Enumeration Date:2005-12-15
Last Update Date:2014-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY210853207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01913753Medicaid
NY41N743Medicare ID - Type Unspecified
NY01913753Medicaid