Provider Demographics
NPI:1700892783
Name:YELLIN, JOSEPH C (DO)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:C
Last Name:YELLIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:1599 E 15TH ST
Mailing Address - Street 2:STE 3
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-6759
Mailing Address - Country:US
Mailing Address - Phone:718-377-2223
Mailing Address - Fax:718-377-4910
Practice Address - Street 1:1599 E 15TH ST
Practice Address - Street 2:STE 3
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-6759
Practice Address - Country:US
Practice Address - Phone:718-377-2223
Practice Address - Fax:718-377-4910
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2017-04-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY1405512084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00797484Medicaid
NY00797484Medicaid
NYB19224Medicare UPIN