Individual provider · Type 1 NPI

Avital Yagudaev, PA

Medical Physician Assistant · Howard Beach, NY

NPI number 1164594156 Active

Practice location

15705 Crossbay Blvd
Howard Beach, NY 11414-2748

Call (718) 845-5252 Map

Fax (718) 845-6464

Mailing address

210 Howard St
East Williston, NY 11596-1420

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700X009742 (NY)

Medical Physician Assistant: Definition to come...

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About NPI 1164594156

Avital Yagudaev, PA's National Provider Identifier is 1164594156, issued on Nov 14, 2006. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Howard Beach, NY. The record was last updated on Jun 6, 2025.