MEDICARE: DR. FAINA YABLOCHNIKOVA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	259519	NY
2	283Q00000X	Psychiatric Hospital	259519	NY
3	2084P0804X	Child & Adolescent Psychiatry Physician	259519	NY

General Provider Information

NPI Number	:	1174768527
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FAINA YABLOCHNIKOVA MD

Provider Business Mailing Address
First Line	:	1382 E 72ND ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-5802
Country	:	US
Telephone Number	:	718-444-0239
Fax Number	:

Provider Business Practice Location Address
First Line	:	2829 OCEAN PKWY STE 2
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-7859
Country	:	US
Telephone Number	:	917-586-7271
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/12/2008
Last Update Date	:	03/11/2026

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