Provider Demographics
NPI:1003061359
Name:ABAYEV, YELENA (DPT)
Entity Type:Individual
Prefix:
First Name:YELENA
Middle Name:
Last Name:ABAYEV
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13701 83RD AVE APT 6F
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11435-1527
Mailing Address - Country:US
Mailing Address - Phone:917-597-4146
Mailing Address - Fax:718-847-0140
Practice Address - Street 1:13701 83RD AVE APT 6F
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11435-1527
Practice Address - Country:US
Practice Address - Phone:917-597-4146
Practice Address - Fax:718-847-0140
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-28
Last Update Date:2008-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0222342251P0200X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic