Provider Demographics
NPI:1619126588
Name:EMAG, LYUDMILA (NP)
Entity Type:Individual
Prefix:
First Name:LYUDMILA
Middle Name:
Last Name:EMAG
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 350822
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-0822
Mailing Address - Country:US
Mailing Address - Phone:347-275-1878
Mailing Address - Fax:
Practice Address - Street 1:2632 E 14TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235
Practice Address - Country:US
Practice Address - Phone:718-375-2100
Practice Address - Fax:800-349-4298
Is Sole Proprietor?:No
Enumeration Date:2008-09-15
Last Update Date:2018-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY304980363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health