Most Relevant Information
Provider Data
| NPI Number: | 1003811720 |
| Provider Name: | RAFAEL YAKUTILOV M.D. |
| Entity Type: | Individual |
| Taxonomy Code: | 2084N0400X |
| Specialty: | Psychiatry & Neurology |
| License Number: | 229375 |
Most Important Dates
| Enumeration Date: | 06/17/2005 |
| Last Updated: | 01/30/2009 |
Provider Practice Location
15 BEACH 105TH ST
ROCKAWAY PARK
NY
116942640
Practice Location Phone/Fax
| Phone: | 7184740023 |
| Fax: | 7184742033 |
Provider Mailing Location
15 BEACH 105TH ST
ROCKAWAY PARK
NY
116942640
Provider Mailing Phone/Fax
| Phone: | 7184740023 |
| Fax: | 7184742033 |
Suggested EMR
Neurology EMR