Provider Demographics
NPI:1639660921
Name:YEHUDAI, DEBORAH ELIZABETH (LPN)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:ELIZABETH
Last Name:YEHUDAI
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 BARNWELL LN
Mailing Address - Street 2:
Mailing Address - City:STONY BROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11790-2603
Mailing Address - Country:US
Mailing Address - Phone:631-835-0011
Mailing Address - Fax:
Practice Address - Street 1:CHRISTIAN NURSING REGISTRY
Practice Address - Street 2:17 BANK AVENUE
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787
Practice Address - Country:US
Practice Address - Phone:631-265-5300
Practice Address - Fax:631-265-5789
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-23
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY316270164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse