Provider Demographics
NPI:1831562347
Name:EVIN, YEVA
Entity type:Individual
Prefix:
First Name:YEVA
Middle Name:
Last Name:EVIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2630 CROPSEY AVE
Mailing Address - Street 2:APT 14G
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-6757
Mailing Address - Country:US
Mailing Address - Phone:917-648-9313
Mailing Address - Fax:
Practice Address - Street 1:2630 CROPSEY AVE
Practice Address - Street 2:APT 14G
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-6757
Practice Address - Country:US
Practice Address - Phone:917-648-9313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-05
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF338390-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily