Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 022234 | NY |
N | 2251X0800X | Physical Therapist - Orthopedic | 022234 | NY |
NPI | 1003061359 |
---|---|
Provider Name | Yelena Abayev |
First Address | Jamaica, NY 11435-1527 |
Second Address | Jamaica, NY 11435-1527 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/11/2008 |
Last Update Date | 28/11/2008 |