Provider Demographics
NPI:1467137133
Name:KUCHYNSKA, YANA (OD)
Entity type:Individual
Prefix:
First Name:YANA
Middle Name:
Last Name:KUCHYNSKA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8320 SILVER FOX RD
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40291-2671
Mailing Address - Country:US
Mailing Address - Phone:347-884-7497
Mailing Address - Fax:
Practice Address - Street 1:134 KINGSLAND RD STE 3
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07014-1915
Practice Address - Country:US
Practice Address - Phone:973-405-2548
Practice Address - Fax:973-777-2060
Is Sole Proprietor?:No
Enumeration Date:2023-06-20
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00732800152W00000X
KY2331DT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist