Provider Demographics
NPI:1740873843
Name:LYPCHUK CHOKAN, NATALIIA M
Entity type:Individual
Prefix:
First Name:NATALIIA
Middle Name:M
Last Name:LYPCHUK CHOKAN
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 1:90 S BEDFORD RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-3412
Mailing Address - Country:US
Mailing Address - Phone:914-242-1370
Mailing Address - Fax:914-242-1371
Practice Address - Street 1:90 S BEDFORD RD
Practice Address - Street 2:
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-3412
Practice Address - Country:US
Practice Address - Phone:914-242-1370
Practice Address - Fax:914-242-1371
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-19
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF347044363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner