Active NPI
Williamsburg Medical of New York LLC
- Vascular & Interventional Radiology Physician
- Hewlett, NY
National Provider Identifier
1740100858
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular & Interventional Radiology Physician
- Legal business name
- WILLIAMSBURG MEDICAL OF NEW YORK LLC
- Practice address
- 1229 Broadway Ste 103
Hewlett, NY 11557-2014 - Phone
- (847) 257-1244
- NPI assigned
- Jul 18, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Yan Katsnelson
- Title
- Ceo
- Phone
- (847) 774-5300
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | |||
| Vascular & Interventional Radiology Physician | 2085R0204X | Primary | ||
| Vascular Surgery Physician | 2086S0129X |
Addresses
Primary practice location
1229 Broadway Ste 103
Hewlett, NY 11557-2014
Mailing address
PO Box 32
Northbrook, IL 60065-0032
Other practice location 1
2511 Ocean Ave Ste 102
Brooklyn, NY 11229-3957
Phone (847) 257-1244
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1784332800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1784851200000",
"number": "1740100858",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 32",
"city": "NORTHBROOK",
"state": "IL",
"postal_code": "600650032"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1229 BROADWAY STE 103",
"city": "HEWLETT",
"state": "NY",
"postal_code": "115572014",
"telephone_number": "847-257-1244"
}
],
"practiceLocations": [
{
"address_1": "2511 Ocean Ave Ste 102",
"address_purpose": "LOCATION",
"city": "Brooklyn",
"state": "NY",
"postal_code": "112293957",
"country_code": "US",
"telephone_number": "847-257-1244",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "WILLIAMSBURG MEDICAL OF NEW YORK LLC",
"organizational_subpart": "NO",
"enumeration_date": "2026-07-18",
"last_updated": "2026-07-24",
"certification_date": "2026-07-24",
"status": "A",
"authorized_official_last_name": "KATSNELSON",
"authorized_official_first_name": "YAN",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "847-774-5300",
"authorized_official_name_prefix": "Dr."
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "2085R0204X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Radiology, Vascular & Interventional Radiology",
"state": null,
"license": null,
"primary": true
},
{
"code": "2086S0129X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Surgery, Vascular Surgery",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Hewlett, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.