Provider Demographics
NPI:1124287008
Name:YUZBASHYAN, TATYANA (MD)
Entity type:Individual
Prefix:DR
First Name:TATYANA
Middle Name:
Last Name:YUZBASHYAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5010 44TH ST
Mailing Address - Street 2:
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-7320
Mailing Address - Country:US
Mailing Address - Phone:718-275-5200
Mailing Address - Fax:718-275-6864
Practice Address - Street 1:97-01 66TH AVE.
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374
Practice Address - Country:US
Practice Address - Phone:718-275-5200
Practice Address - Fax:718-275-6864
Is Sole Proprietor?:No
Enumeration Date:2008-06-05
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2581272084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology