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General NPI Number Information
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NPI Number | 1447723986
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Entity Type | Organization
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Legal Business Name | YA ANESTHESIA NY PC
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Dates
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Enumeration Date | 01/08/2019
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Last Update Date | 08/25/2022
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Provider Practice Location Address
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Address Line | 6240 WOODHAVEN BLVD STE P17
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City | REGO PARK
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State | NY
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Zip | 11374-3702
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Country | US
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Telephone | 718-200-8846
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Fax |
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Provider Business Mailing Address
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Address Line | 6240 WOODHAVEN BLVD STE P17
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City | REGO PARK
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State | NY
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Zip | 11374-3702
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Country | US
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Telephone | 718-200-8846
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Fax |
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Authorized Official
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Title or Position | MD
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Name | YAKUB ABRAKHIMOV
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Credential |
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Telephone | 718-675-9219
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State |
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