Provider Demographics
NPI:1952667107
Name:COVIN, YVONNE NICOLLE (MD)
Entity Type:Individual
Prefix:DR
First Name:YVONNE
Middle Name:NICOLLE
Last Name:COVIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:YVONNE
Other - Middle Name:NICOLLE
Other - Last Name:WATKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:600 W 168TH ST # VC-205
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3743
Mailing Address - Country:US
Mailing Address - Phone:212-305-6262
Mailing Address - Fax:
Practice Address - Street 1:600 W 168TH ST # VC-205
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3743
Practice Address - Country:US
Practice Address - Phone:212-305-6262
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-02
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ4738207R00000X
NY277018207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX350524003Medicaid
TX350524004OtherCSHCN