Provider Demographics
NPI:1013233915
Name:UMANA-CHAN, YULISA
Entity Type:Individual
Prefix:DR
First Name:YULISA
Middle Name:
Last Name:UMANA-CHAN
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 1:24928 RUSHMORE TER
Mailing Address - Street 2:
Mailing Address - City:LITTLE NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11362-1326
Mailing Address - Country:US
Mailing Address - Phone:516-850-6526
Mailing Address - Fax:
Practice Address - Street 1:24928 RUSHMORE TER
Practice Address - Street 2:
Practice Address - City:LITTLE NECK
Practice Address - State:NY
Practice Address - Zip Code:11362-1326
Practice Address - Country:US
Practice Address - Phone:516-850-6526
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-16
Last Update Date:2010-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0324972251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics