Provider Demographics
NPI:1649539131
Name:YEMCHUK, LYUBOV (LPN)
Entity type:Individual
Prefix:
First Name:LYUBOV
Middle Name:
Last Name:YEMCHUK
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 TRAVERS CIR
Mailing Address - Street 2:APT B
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14228-1723
Mailing Address - Country:US
Mailing Address - Phone:716-573-9281
Mailing Address - Fax:
Practice Address - Street 1:205 TRAVERS CIR
Practice Address - Street 2:APT B
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14228-1723
Practice Address - Country:US
Practice Address - Phone:716-573-9281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-03
Last Update Date:2012-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY308693-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse