Provider Demographics
NPI:1104149848
Name:YASAYEVA, YULIYA (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:YULIYA
Middle Name:
Last Name:YASAYEVA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10849 63RD AVE APT 2A
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-1360
Mailing Address - Country:US
Mailing Address - Phone:347-832-5351
Mailing Address - Fax:
Practice Address - Street 1:21508 73RD AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11364-2949
Practice Address - Country:US
Practice Address - Phone:718-479-2782
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-09
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY053897-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist