Provider Demographics
NPI:1982973350
Name:VEGA, YVETTE D (RN)
Entity Type:Individual
Prefix:MRS
First Name:YVETTE
Middle Name:D
Last Name:VEGA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:YVETTE
Other - Middle Name:D
Other - Last Name:WILKINSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:400 CROOKED HILL RD BLDG 2
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11717-1039
Mailing Address - Country:US
Mailing Address - Phone:631-231-3232
Mailing Address - Fax:
Practice Address - Street 1:400 CROOKED HILL RD BLDG 2
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:NY
Practice Address - Zip Code:11717-1039
Practice Address - Country:US
Practice Address - Phone:631-231-3232
Practice Address - Fax:631-339-7541
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-14
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY648695163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse