Provider Demographics
NPI:1780186791
Name:PINN, YAEL (PA-C)
Entity Type:Individual
Prefix:MS
First Name:YAEL
Middle Name:
Last Name:PINN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:YAEL
Other - Middle Name:
Other - Last Name:HERSKOVITS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:3901 INDEPENDENCE AVE APT 1G
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-1275
Mailing Address - Country:US
Mailing Address - Phone:646-522-0050
Mailing Address - Fax:
Practice Address - Street 1:2701 QUEENS PLZ N
Practice Address - Street 2:
Practice Address - City:LONG ISLAND CITY
Practice Address - State:NY
Practice Address - Zip Code:11101
Practice Address - Country:US
Practice Address - Phone:844-404-1974
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-06
Last Update Date:2018-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021896-1363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant