Provider Demographics
NPI:1962503870
Name:YAKIREVICH, NATALYA V (DC)
Entity Type:Individual
Prefix:DR
First Name:NATALYA
Middle Name:V
Last Name:YAKIREVICH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2333 DIAMOND HILL RD
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:RI
Mailing Address - Zip Code:02864-4703
Mailing Address - Country:US
Mailing Address - Phone:401-334-0535
Mailing Address - Fax:401-334-0102
Practice Address - Street 1:2333 DIAMOND HILL RD
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:RI
Practice Address - Zip Code:02864-4703
Practice Address - Country:US
Practice Address - Phone:401-334-0535
Practice Address - Fax:401-334-0102
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2009-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDCP000542111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
1962503870OtherTUFTS
RI413607OtherBLUECHIP FOR BCBS OF RI
1962503870OtherMEDICARE NHIC
2417981OtherCIGNA
RI31696-1OtherBCBS OF RI