Provider Demographics
NPI:1821297615
Name:YAVIN, AYLA (MS LAC)
Entity Type:Individual
Prefix:
First Name:AYLA
Middle Name:
Last Name:YAVIN
Suffix:
Gender:F
Credentials:MS LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 W 29TH ST RM 1103
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-5224
Mailing Address - Country:US
Mailing Address - Phone:917-331-2694
Mailing Address - Fax:718-852-4586
Practice Address - Street 1:135 W 29TH ST RM 1103
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-5224
Practice Address - Country:US
Practice Address - Phone:917-331-2694
Practice Address - Fax:718-852-4586
Is Sole Proprietor?:No
Enumeration Date:2007-07-12
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY25003580171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist