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General NPI Number Information
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NPI Number | 1841870094
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Entity Type | Individual
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Provider Name | MS. ROKHILA YAKUBOVA
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Gender | Female
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Dates
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Enumeration Date | 04/12/2021
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Last Update Date | 04/12/2021
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Provider Practice Location Address
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Address Line | 2447 EASTCHESTER RD
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City | BRONX
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State | NY
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Zip | 10469-5915
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Country | US
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Telephone | 347-682-1780
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Fax |
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Provider Business Mailing Address
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Address Line | 105 81ST AVE
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City | KEW GARDENS
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State | NY
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Zip | 11415-1107
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Country | US
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Telephone | 347-682-1780
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number | 010726
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License Number State | NY
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