Provider Demographics
NPI:1639759715
Name:VIERA, YULISA F (RN)
Entity Type:Individual
Prefix:
First Name:YULISA
Middle Name:F
Last Name:VIERA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:YULISA
Other - Middle Name:F
Other - Last Name:MENENDEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:29 W MALTBIE AVE
Mailing Address - Street 2:
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-5939
Mailing Address - Country:US
Mailing Address - Phone:973-932-9515
Mailing Address - Fax:
Practice Address - Street 1:300 CORPORATE BLVD S
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-6862
Practice Address - Country:US
Practice Address - Phone:833-637-3866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-12
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY811036163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse