Etlis, Yanina
Etlis, Yanina is an sole proprietor health care provider with primary practice located at 9785 Queens Blvd , Rego Park NY 11374-3319. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Etlis, Yanina can be contacted via phone (718) 261-9100.Contact Information
Primary practice address
9785 Queens Blvd
Rego Park NY 11374-3319
Phone: (718) 261-9100
Fax: (718) 261-6483
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 228241 | New York |
Profile Details
| NPI number | 1730160920 |
|---|---|
| LBN Legal business name | Etlis, Yanina |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 7th, 2005 |
| Last updated | Mar 29th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1730160920 | NPPES |
| New York | MEDICAID | 02462251 |
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