Lilia Yakutelov, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

012487 Issued in NY

Practice address

410 Lakeville Rd
New Hyde Park, NY 11042-1101

Phone

(718) 470-8784

NPI assigned

Apr 7, 2008

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1207526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412553600000",
    "number": "1144493578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8318 HOMELAWN ST",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114322150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 LAKEVILLE RD",
            "city": "NEW HYDE PARK",
            "state": "NY",
            "postal_code": "110421101",
            "telephone_number": "718-470-8784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAKUTELOV",
        "first_name": "LILIA",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-07",
        "last_updated": "2014-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "012487",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "059737",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sanam Yaghoubian, M.D.
• Yasaman Cochava Yaghoubian
• Michelle Yagudaev, RN
• Berta Yagudayeva
• Ester Yakubova
• Jaclyn Yamada
• Kelly Yan, PHARMD
• Laurel Yan, DMD
• Deyun Yang, MD
• Jane Yang, M.D.

• Medical Physician Assistant in New Hyde Park, NY
• Providers in New Hyde Park, NY by specialty
• Medical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.