Provider Demographics
NPI:1124758693
Name:JANKIE, YVONNE (LMT)
Entity type:Individual
Prefix:MS
First Name:YVONNE
Middle Name:
Last Name:JANKIE
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:168 BEACH 119TH ST FL 1
Mailing Address - Street 2:
Mailing Address - City:ROCKAWAY PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11694-1953
Mailing Address - Country:US
Mailing Address - Phone:917-741-6823
Mailing Address - Fax:
Practice Address - Street 1:168 BEACH 119TH ST FL 1
Practice Address - Street 2:
Practice Address - City:ROCKAWAY PARK
Practice Address - State:NY
Practice Address - Zip Code:11694-1953
Practice Address - Country:US
Practice Address - Phone:917-741-6823
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-16
Last Update Date:2022-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032825225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist