Provider Demographics
NPI:1740950096
Name:YATABARRY, AMINATA (LPN)
Entity type:Individual
Prefix:
First Name:AMINATA
Middle Name:
Last Name:YATABARRY
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 1:125 FALMOUTH ST APT 19
Mailing Address - Street 2:
Mailing Address - City:GREECE
Mailing Address - State:NY
Mailing Address - Zip Code:14615-1917
Mailing Address - Country:US
Mailing Address - Phone:585-709-4809
Mailing Address - Fax:
Practice Address - Street 1:125 FALMOUTH ST APT 19
Practice Address - Street 2:
Practice Address - City:GREECE
Practice Address - State:NY
Practice Address - Zip Code:14615-1917
Practice Address - Country:US
Practice Address - Phone:585-709-4809
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-17
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY335077-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty