Provider Demographics
NPI:1821446360
Name:MICHAELS, YANA
Entity Type:Individual
Prefix:
First Name:YANA
Middle Name:
Last Name:MICHAELS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:713 YONKERS AVE
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10704-2657
Mailing Address - Country:US
Mailing Address - Phone:914-375-6600
Mailing Address - Fax:347-453-6504
Practice Address - Street 1:713 YONKERS AVE
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10704-2657
Practice Address - Country:US
Practice Address - Phone:914-375-6600
Practice Address - Fax:914-377-1366
Is Sole Proprietor?:No
Enumeration Date:2016-05-25
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016220363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant