Yanina Etlis DO PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

228241 Issued in NY

Legal business name

YANINA ETLIS DO PC

Practice address

3030 Ocean Ave
Suite Aa
Brooklyn, NY 11235-3363

Phone

(646) 250-8282

Fax

(718) 769-2365

NPI assigned

Jul 24, 2006

Organization subpart

No

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

Authorized official

Name

Yanina Etlis, DONPI 1730160920

Title

Medical Director

Phone

(646) 250-8282

Specialties & licenses 1

Addresses

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Yanina Etlis, D.O.

  • Family Medicine Physician
  • Rego Park, NY
  • NPI 1730160920
  NPD (past) Authorized official
• Edouard Etlis, DDS

  • General Practice Dentistry
  • Brooklyn, NY
  • NPI 1013937416
  NPD (past)

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1679595334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 OCEAN AVE",
            "address_2": "SUITE AA",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112353363",
            "telephone_number": "646-250-8282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 OCEAN AVE",
            "address_2": "SUITE AA",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112353363",
            "telephone_number": "646-250-8282",
            "fax_number": "718-769-2365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YANINA ETLIS DO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ETLIS",
        "authorized_official_first_name": "YANINA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "646-250-8282",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "228241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zhaonan Yang
• Zhenyi Yang, LMHC
• Zongfang Yang, NP
• Zarina Yangibayeva
• Sergey Yangolenko, D.D.S.
• Yanina Kovler, M.D., P.C.
• Yanina Kovler, M.D.,P.C
• Kaydene Yankana
• Brent Vincent Yanke, M.D.
• Oleg Yankelevich

• Family Medicine Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.