Provider Demographics
NPI:1720686918
Name:YEHUDA YISRAEL, YAHHILA (CHW, HHP, RYT)
Entity type:Individual
Prefix:MISS
First Name:YAHHILA
Middle Name:
Last Name:YEHUDA YISRAEL
Suffix:
Gender:F
Credentials:CHW, HHP, RYT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 STEVENS AVE STE 408
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10550-2680
Mailing Address - Country:US
Mailing Address - Phone:516-643-4286
Mailing Address - Fax:
Practice Address - Street 1:105 STEVENS AVE
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10550-2686
Practice Address - Country:US
Practice Address - Phone:516-643-4286
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-11
Last Update Date:2022-02-24
Deactivation Date:2020-10-13
Deactivation Code:
Reactivation Date:2021-10-20
Provider Licenses
StateLicense IDTaxonomies
NY174400000X, 172V00000X
175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No174400000XOther Service ProvidersSpecialist
No175F00000XOther Service ProvidersNaturopath