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Allen Yevtukhov

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

475 Seaview Ave, Staten Island, NY 10305-3436

PECOS Enrollment

Based on the most recent information from CMS, provider Allen Yevtukhov is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 6 days ago.

Profile Details

Provider ID
1245958230
Provider Type
Individual
Full Name
Yevtukhov, Allen
Gender
Male

Sole Proprietor
No
Enumeration Date
8/16/2022
Last Updated
8/16/2022

Contact Information

Practice Location

475 Seaview Ave, Staten Island, NY 10305-3436

(718) 226-9158

Unlisted Fax

Mailing Location

475 Seaview Ave, Staten Island, NY 10305-3436

(718) 226-9158

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License Unlisted Issuer

Allen Yevtukhov

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Cho, Eunice

Morales, Laisha Abigail

Cusumano, Nicole Joann

Ingrassia, Michael Anthony

Raineri, Caterina O

Weitzner, Esther

Feyijinmi, Olusegun I

Johnson, Stelin

Youssef, Olivia Mary

Juliano, Jamie E