Provider Demographics
NPI:1861941171
Name:GONZALEZ, YAHAIRA (MSED, TSHH, BE)
Entity type:Individual
Prefix:
First Name:YAHAIRA
Middle Name:
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:MSED, TSHH, BE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2888 HEATHERCREST DR
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598-2429
Mailing Address - Country:US
Mailing Address - Phone:914-471-0690
Mailing Address - Fax:
Practice Address - Street 1:2888 HEATHERCREST DR
Practice Address - Street 2:
Practice Address - City:YORKTOWN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:10598-2429
Practice Address - Country:US
Practice Address - Phone:914-471-0690
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-27
Last Update Date:2016-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist