Provider Demographics
NPI:1699186213
Name:KHEYFETS, YULIYA
Entity Type:Individual
Prefix:
First Name:YULIYA
Middle Name:
Last Name:KHEYFETS
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 1:8735 BAY PKWY
Mailing Address - Street 2:APT. B26
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-5158
Mailing Address - Country:US
Mailing Address - Phone:917-331-7801
Mailing Address - Fax:
Practice Address - Street 1:8735 BAY PKWY
Practice Address - Street 2:APT. B26
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-5158
Practice Address - Country:US
Practice Address - Phone:718-373-1324
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-16
Last Update Date:2014-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY644671121174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist