Provider Demographics
NPI:1033380688
Name:PINKHASOV, ABO (NP)
Entity Type:Individual
Prefix:
First Name:ABO
Middle Name:
Last Name:PINKHASOV
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6910 YELLOWSTONE BLVD
Mailing Address - Street 2:APARTMENT 220
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-3762
Mailing Address - Country:US
Mailing Address - Phone:917-969-7071
Mailing Address - Fax:
Practice Address - Street 1:525 EAST 68 STREET
Practice Address - Street 2:EMERGENCY ROOM
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021
Practice Address - Country:US
Practice Address - Phone:212-746-0795
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-21
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF303817-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health