Provider Demographics
NPI:1639287568
Name:YAKANA INC
Entity Type:Organization
Organization Name:YAKANA INC
Other - Org Name:YAKANA MEDICAL SUPPLIES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:YAKOU
Authorized Official - Middle Name:
Authorized Official - Last Name:KANCHIK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-232-0717
Mailing Address - Street 1:1551 BATH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11228
Mailing Address - Country:US
Mailing Address - Phone:718-232-0717
Mailing Address - Fax:718-234-0591
Practice Address - Street 1:1551 BATH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11228
Practice Address - Country:US
Practice Address - Phone:718-232-0717
Practice Address - Fax:718-234-0591
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
4763590001Medicare ID - Type Unspecified