Provider Demographics
NPI:1912728254
Name:VASQUEZ, YANIQUE L (FNP-C)
Entity type:Individual
Prefix:MS
First Name:YANIQUE
Middle Name:L
Last Name:VASQUEZ
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11911 164TH ST APT 1
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11434-5741
Mailing Address - Country:US
Mailing Address - Phone:347-551-7395
Mailing Address - Fax:
Practice Address - Street 1:11911 164TH ST APT 1
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11434-5741
Practice Address - Country:US
Practice Address - Phone:347-551-7395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY354389363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily