Provider Demographics
NPI:1588806673
Name:YAMPOLSKY, JULIA
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:YAMPOLSKY
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 1:280 QUENTIN RD
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-1628
Mailing Address - Country:US
Mailing Address - Phone:718-336-4499
Mailing Address - Fax:718-336-2013
Practice Address - Street 1:280 QUENTIN RD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-1628
Practice Address - Country:US
Practice Address - Phone:718-336-4499
Practice Address - Fax:718-336-2013
Is Sole Proprietor?:No
Enumeration Date:2009-04-03
Last Update Date:2010-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019652225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02325611Medicaid