Provider Demographics
NPI:1154298081
Name:KRIMSKY, YOCHEVED MIRIAM (STUDENT)
Entity type:Individual
Prefix:
First Name:YOCHEVED
Middle Name:MIRIAM
Last Name:KRIMSKY
Suffix:
Gender:F
Credentials:STUDENT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 EDEN RD
Mailing Address - Street 2:
Mailing Address - City:LIDO BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11561-4815
Mailing Address - Country:US
Mailing Address - Phone:203-918-8282
Mailing Address - Fax:
Practice Address - Street 1:19 EDEN RD
Practice Address - Street 2:
Practice Address - City:LIDO BEACH
Practice Address - State:NY
Practice Address - Zip Code:11561-4815
Practice Address - Country:US
Practice Address - Phone:203-918-8282
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-23
Last Update Date:2025-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY582317-01363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily