Provider Demographics
NPI:1750634689
Name:VAN OSTRAND, YULIYA (RN)
Entity Type:Individual
Prefix:
First Name:YULIYA
Middle Name:
Last Name:VAN OSTRAND
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:574 RIVERSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-4842
Mailing Address - Country:US
Mailing Address - Phone:516-659-3421
Mailing Address - Fax:516-795-4090
Practice Address - Street 1:574 RIVERSIDE AVE
Practice Address - Street 2:
Practice Address - City:MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-4842
Practice Address - Country:US
Practice Address - Phone:516-659-3421
Practice Address - Fax:516-795-4090
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-16
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY641521163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse