Provider Demographics
NPI:1811315898
Name:ADHAR, YAVITRIE
Entity type:Individual
Prefix:
First Name:YAVITRIE
Middle Name:
Last Name:ADHAR
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 1:12104 LIBERTY AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:SOUTH RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11419-2112
Mailing Address - Country:US
Mailing Address - Phone:718-322-8121
Mailing Address - Fax:
Practice Address - Street 1:1111 AMSTERDAM AVE.
Practice Address - Street 2:ST. LUKES HOSPITAL
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10035
Practice Address - Country:US
Practice Address - Phone:718-322-8121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-07
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY551493163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse