Provider Demographics
NPI:1740642693
Name:YASHAEV, ELEANOR (MS)
Entity type:Individual
Prefix:
First Name:ELEANOR
Middle Name:
Last Name:YASHAEV
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2940 OCEAN PKWY
Mailing Address - Street 2:APT 5V
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-8200
Mailing Address - Country:US
Mailing Address - Phone:347-885-8065
Mailing Address - Fax:
Practice Address - Street 1:2940 OCEAN PKWY
Practice Address - Street 2:APT 5V
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-8200
Practice Address - Country:US
Practice Address - Phone:347-885-8065
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-21
Last Update Date:2016-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist