Healthcare Provider Details

I. General information

NPI: 1093743197
Provider Name (Legal Business Name): B & Y MEDICAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 06/10/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9752 64TH AVE FL 1
REGO PARK NY
11374-2204
US

IV. Provider business mailing address

9934 65TH RD
REGO PARK NY
11374-3655
US

V. Phone/Fax

Practice location:
  • Phone: 718-830-0002
  • Fax: 718-830-0006
Mailing address:
  • Phone: 718-830-0002
  • Fax: 718-830-0006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number240076
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. BORIS ABAYEV
Title or Position: DIRECTOR
Credential: MD
Phone: 718-830-0002