Provider Demographics
NPI:1801025093
Name:GREENFIELD, YVONNE ANN (RPAC)
Entity Type:Individual
Prefix:MRS
First Name:YVONNE
Middle Name:ANN
Last Name:GREENFIELD
Suffix:
Gender:F
Credentials:RPAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:93 WYCKOFF ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-6305
Mailing Address - Country:US
Mailing Address - Phone:718-875-3326
Mailing Address - Fax:
Practice Address - Street 1:153 4TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11217-3108
Practice Address - Country:US
Practice Address - Phone:718-230-5811
Practice Address - Fax:718-230-5836
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-08
Last Update Date:2009-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008114-1363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical