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General NPI Number Information
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NPI Number | 1942186838
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Entity Type | Individual
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Provider Name | MOSHIAH YAKUBOV PT
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Gender | Male
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Dates
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Enumeration Date | 08/14/2025
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Last Update Date | 08/14/2025
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Provider Practice Location Address
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Address Line | 8740 165TH ST APT 1N
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City | JAMAICA
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State | NY
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Zip | 11432-3501
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Country | US
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Telephone | 917-670-8258
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Fax |
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Provider Business Mailing Address
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Address Line | 14429 78TH AVE
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City | FLUSHING
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State | NY
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Zip | 11367-3430
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Country | US
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Telephone |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 052352
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License Number State | NY
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