Provider Demographics
NPI:1265766323
Name:YEVSIKOVA, OLGA (MD)
Entity type:Individual
Prefix:
First Name:OLGA
Middle Name:
Last Name:YEVSIKOVA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1849 86TH ST
Mailing Address - Street 2:INTERMED CARE PC
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-3108
Mailing Address - Country:US
Mailing Address - Phone:718-331-9600
Mailing Address - Fax:
Practice Address - Street 1:1849 86TH ST
Practice Address - Street 2:INTERMED CARE PC
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11214-3108
Practice Address - Country:US
Practice Address - Phone:718-331-9600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-22
Last Update Date:2014-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY277131207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine