Provider Demographics
NPI:1053127589
Name:FAINA YABLOCHNIKOVA MEDICAL SERVICES PC
Entity type:Organization
Organization Name:FAINA YABLOCHNIKOVA MEDICAL SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FAINA
Authorized Official - Middle Name:
Authorized Official - Last Name:YABLOCHNIKOVA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-586-7271
Mailing Address - Street 1:1382 E 72ND ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-5802
Mailing Address - Country:US
Mailing Address - Phone:347-328-2720
Mailing Address - Fax:
Practice Address - Street 1:3380 NOSTRAND AVE APT 1E
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-4032
Practice Address - Country:US
Practice Address - Phone:347-792-6916
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-09
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty