Provider Demographics
NPI:1366790065
Name:SUNDATOVA, YULIYA (RN, FNP)
Entity type:Individual
Prefix:MISS
First Name:YULIYA
Middle Name:
Last Name:SUNDATOVA
Suffix:
Gender:F
Credentials:RN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RADIATION ONCOLOGY
Mailing Address - Street 2:10UNION SQUARE EAST
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003
Mailing Address - Country:US
Mailing Address - Phone:212-844-8089
Mailing Address - Fax:
Practice Address - Street 1:325 WEST 15TH ST,ROOM C 47
Practice Address - Street 2:BETH ISRAEL COMPREHENSIVE CANCER CENTERDEPT OF RADIATIO
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011
Practice Address - Country:US
Practice Address - Phone:212-367-1733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-28
Last Update Date:2016-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF337446-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily