1013099126 NPI number — LYUDMILA GABRIEL CAVALIER MD

Table of content: LYUDMILA GABRIEL CAVALIER MD (NPI 1013099126)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013099126 NPI number — LYUDMILA GABRIEL CAVALIER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CAVALIER
Provider First Name:
LYUDMILA
Provider Middle Name:
GABRIEL
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
YUSHVAYEV
Provider Other First Name:
LYUDMILA
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1013099126
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9014 FLATLANDS AVENUE
Provider Second Line Business Mailing Address:
LYUDMILA CAVALIER PHYSICIAN PC
Provider Business Mailing Address City Name:
BROOKLYN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11236
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-209-5353
Provider Business Mailing Address Fax Number:
718-209-1745

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9014 FLATLANDS AVENUE
Provider Second Line Business Practice Location Address:
LYUDMILA CAVALIER PHYSICIAN PC
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11236
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-209-5353
Provider Business Practice Location Address Fax Number:
718-209-1745
Provider Enumeration Date:
10/19/2006

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: 208000000X , with the licence number:  207531 , 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)

  • Identifier: 01828239 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com