Provider Demographics
NPI:1871266148
Name:MCDONALD, YANIEK KAYDIAN (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:DR
First Name:YANIEK
Middle Name:KAYDIAN
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:647 E 232ND ST APT 5D
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10466-2945
Mailing Address - Country:US
Mailing Address - Phone:917-443-8743
Mailing Address - Fax:
Practice Address - Street 1:647 E 232ND ST APT 5D
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10466-2945
Practice Address - Country:US
Practice Address - Phone:917-443-8743
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-31
Last Update Date:2021-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF432049-01363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner