LILIA YAKUTELOV (NPI# 1144493578) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144493578 |
| Entity Type | Individual |
| Full Name | LILIA YAKUTELOV |
| Credential | PA |
| Practice Address |
410 Lakeville Rd New Hyde Park NY 11042-1101 |
| Mailing Address |
8318 Homelawn St Jamaica NY 11432-2150 |
| Practice Telephone | 7184708784 |
| Enumeration Date | 2008-04-07 |
| Last Update Date | 2014-10-06 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 183500000X | Pharmacist | 059737 | NY | Pharmacy Service Providers |
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
012487 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
410 LAKEVILLE RD |
| City | NEW HYDE PARK |
| State | NY |
| Zip Code | 11042-1101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043825201 | Shoaba Jaikissoon | Nurse Practitioner | 410 Lakeville Rd, New Hyde Park, NY 11042-1101 | 2020-09-14 |
| 1306484472 | Lauren Procaccino | Physician Assistant | 410 Lakeville Rd, New Hyde Park, NY 11042-1101 | 2019-12-19 |
| 1881231165 | Angelica Corrigan | Social Worker | 410 Lakeville Rd, New Hyde Park, NY 11042-1101 | 2019-12-05 |
| 1861991259 | Advanced Cardiovascular Diagnostics Pllc | Internal Medicine | 410 Lakeville Rd, New Hyde Park, NY 11042-1101 | 2018-02-12 |
| 1043725823 | Rachel Lowy | Physician Assistant | 410 Lakeville Rd, New Hyde Park, NY 11042-1101 | 2017-12-03 |
| 1659730638 | Kathleen Ann O'connor | Nurse Practitioner | 410 Lakeville Rd, New Hyde Park, NY 11042-1101 | 2016-02-18 |
| 1356719082 | Ari Leonard Ginsberg Md Pllc | Specialist | 410 Lakeville Rd, 100, New Hyde Park, NY 11042-1101 | 2015-09-11 |
| 1720462534 | Katherine Hogan | Nurse Practitioner | 410 Lakeville Rd, New Hyde Park, NY 11042-1101 | 2015-07-13 |
| 1669854832 | True North Health Pharmacy, Inc. | Pharmacy | 410 Lakeville Rd, Suite 102, New Hyde Park, NY 11042-1101 | 2015-06-24 |
| 1306284930 | Restorative Medicine, P.C. | Physical Medicine & Rehabilitation | 410 Lakeville Rd, Suite 303, New Hyde Park, NY 11042-1101 | 2013-06-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649871260 | Advanced Cardiovascular Diagnostics, Pllc | Internal Medicine | 410 Lakeville Road Suite 209, New Hyde Park, NY 11042 | 2020-11-02 |
| 1568093771 | Global Slp Ot Pt & Psychological Services, Pllc | Physical Therapist | 1979 Marcus Avenue - Suite 204, Attn: Jon Polish, Lake Success, NY 11042 | 2020-01-28 |
| 1730745761 | Miriam Korbman | Psychologist | 2001 Marcus Ave Suite E128, Lake Success, NY 11042 | 2019-05-15 |
| 1306402409 | Swachi Jain | Student in an Organized Health Care Education/Training Program | Northwell Health Pathology, 6 - Ohio Drive, Suite 202, Lake Success, NY 11042 | 2019-05-14 |
| 1215407432 | Samara Carly Badash | Physical Therapist | Brookville Center for Children's Services, 1983 Marcus Avenue, Suite E100, New Hyde Park, NY 11042 | 2018-11-30 |
| 1720578578 | Nidhi Kataria | Student in an Organized Health Care Education/Training Program | Department of Pathology and Laboratory Medicine, Northw, 6 Ohio Drive, Suite 202, Lake Success, NY 11042 | 2018-05-17 |
| 1558870162 | Rosemary Elizabeth Fine | Nurse Practitioner | 1999 Marcus Ave Ste 306, New Hyde Park, NY 11042 | 2017-09-26 |
| 1255861159 | Nicole Renee Cohen | Speech-Language Pathologist | 1893 Marcus Ave, C118, New Hyde Park, NY 11042 | 2017-06-14 |
| 1366807943 | Molly Rubinoff | Nurse Practitioner | 1215 One Hollow Lane, #301, New Hyde Park, NY 11042 | 2015-12-23 |
| 1255701959 | Prohealth Dental Pllc | Dentist | 1 Pro Health Plz, Suite 115, New Hyde Park, NY 11042 | 2015-10-07 |
| Find all providers in zip 11042 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124636188 | Shannon Maureen O'connell | Physician Assistant | 270-05 270th Ave, New Hyde Park, NY 11040 | 2020-07-16 |
| 1841818895 | Yanick Dugue | Physician Assistant | 4 Lincoln Ave, New Hyde Park, NY 11040-3125 | 2020-07-07 |
| 1922633304 | Jenny Thomas | Physician Assistant | 21 New Hyde Park Rd, New Hyde Park, NY 11040-4938 | 2020-03-06 |
| 1487207536 | Rebecca Kaffash | Physician Assistant | 1 Hollow Ln Ste 315, New Hyde Park, NY 11042-1215 | 2019-07-18 |
| 1528482122 | Anu George | Physician Assistant | 560 7th Avenue, New Hyde Park, NY 11040 | 2014-02-18 |
| 1003150699 | Abdul H Sayed | Physician Assistant | 2 Ohio Dr Ste 201, New Hyde Park, NY 11042-1111 | 2012-11-20 |
| 1427188598 | Yaron Shalomoff | Physician Assistant | 1 Dakota Dr Ste 310, New Hyde Park, NY 11042-1136 | 2007-03-06 |
| 1255425062 | Patrick A Marrone | Physician Assistant | Nslij 270-05 76th Ave, New Hyde Park, NY 11040-1433 | 2006-10-03 |
| 1679667752 | Joanna Cohen | Physician Assistant | 1999 Marcus Ave Ste 120, New Hyde Park, NY 11042-1017 | 2006-10-03 |
| 1336786888 | Sandra Mozie | Physician Assistant | 27005 76th Ave, New Hyde Park, NY 11040-1402 | 2019-12-03 |
| Find all providers in NEW HYDE PARK | ||||
| City | NEW HYDE PARK |
| Zip Code | 11042 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.