| Rafael Yakutilov Neurology, Pc | |
|
15 Beach 105th St Rockaway Park NY 11694-2640 | |
| (718) 474-0023 | |
| (718) 474-2033 |
| Full Name | Rafael Yakutilov Neurology, Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 15 Beach 105th St, Rockaway Park, New York |
| Authorized Official Name and Position | Rafael Yakutilov (PHYSICIAN, NEUROLOGIST) |
| Authorized Official Contact | 7184740023 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rafael Yakutilov Neurology, Pc 15 Beach 105th St Rockaway Park NY 11694-2640 Ph: (718) 474-0023 | Rafael Yakutilov Neurology, Pc 15 Beach 105th St Rockaway Park NY 11694-2640 Ph: (718) 474-0023 |
| NPI Number | 1073708269 |
|---|---|
| Provider Enumeration Date | 09/11/2007 |
| Last Update Date | 01/30/2009 |
| Medicare PECOS PAC ID | 0042307688 |
|---|---|
| Medicare Enrollment ID | O20081217000178 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073708269 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
| Provider Name | Rafael Yakutilov |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1003811720 PECOS PAC ID: 2163404245 Enrollment ID: I20040602001429 |
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