Provider Demographics
NPI:1710293048
Name:YUNAYEV, SHAWN ILSHA (MD)
Entity Type:Individual
Prefix:
First Name:SHAWN
Middle Name:ILSHA
Last Name:YUNAYEV
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6410 VETERANS AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-5605
Mailing Address - Country:US
Mailing Address - Phone:718-209-6400
Mailing Address - Fax:718-209-6060
Practice Address - Street 1:6410 VETERANS AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-5605
Practice Address - Country:US
Practice Address - Phone:718-209-6400
Practice Address - Fax:718-209-6060
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-24
Last Update Date:2014-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY257837207R00000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine