Provider Demographics
NPI:1144457698
Name:ABRAKHIMOV, YAKUB (MD)
Entity type:Individual
Prefix:
First Name:YAKUB
Middle Name:
Last Name:ABRAKHIMOV
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6240 WOODHAVEN BLVD STE P17
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-3702
Mailing Address - Country:US
Mailing Address - Phone:718-200-8846
Mailing Address - Fax:
Practice Address - Street 1:6240 WOODHAVEN BLVD STE P17
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-3702
Practice Address - Country:US
Practice Address - Phone:718-200-8846
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-11
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY264776207L00000X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology