Provider Demographics
NPI:1881242915
Name:YANOVSKIY, VALENTINA (OD)
Entity type:Individual
Prefix:
First Name:VALENTINA
Middle Name:
Last Name:YANOVSKIY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 KENSINGTON ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-3025
Mailing Address - Country:US
Mailing Address - Phone:646-283-1758
Mailing Address - Fax:
Practice Address - Street 1:519 5TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-7372
Practice Address - Country:US
Practice Address - Phone:718-768-1020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-02
Last Update Date:2019-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009034152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist