Provider Demographics
NPI:1891018107
Name:FAMILUSI, YVONNETTE M (REGISTERED NURSE)
Entity type:Individual
Prefix:MS
First Name:YVONNETTE
Middle Name:M
Last Name:FAMILUSI
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:MISS
Other - First Name:YVONNETTE
Other - Middle Name:M
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:REGISTERED NURSE
Mailing Address - Street 1:1 FAMILUSI CT
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-4877
Mailing Address - Country:US
Mailing Address - Phone:631-757-3771
Mailing Address - Fax:631-757-3771
Practice Address - Street 1:1 FAMILUSI CT
Practice Address - Street 2:YVONNETTE FAMILUSI
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-4877
Practice Address - Country:US
Practice Address - Phone:631-757-3771
Practice Address - Fax:631-757-3771
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-02
Last Update Date:2019-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY481444-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse