1033990346 NPI number — ESTRELLE ADELLE SILVA YBURAN PT

Table of content: ESTRELLE ADELLE SILVA YBURAN PT (NPI 1033990346)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033990346 NPI number — ESTRELLE ADELLE SILVA YBURAN PT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
YBURAN
Provider First Name:
ESTRELLE ADELLE
Provider Middle Name:
SILVA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033990346
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/22/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6370 WOODHAVEN BLVD.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
REGO PARK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11374
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
929-335-7707
Provider Business Mailing Address Fax Number:
929-335-7709

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6370 WOODHAVEN BLVD.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
REGO PARK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11374
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
929-335-7707
Provider Business Practice Location Address Fax Number:
929-335-7709
Provider Enumeration Date:
10/12/2023

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  050072 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com