Provider Demographics
NPI:1174339287
Name:R.Y. FNP PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:R.Y. FNP PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RAFAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:YAAKABOV
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:347-836-3045
Mailing Address - Street 1:211 ESSEX ST STE 106
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-3244
Mailing Address - Country:US
Mailing Address - Phone:347-836-3045
Mailing Address - Fax:
Practice Address - Street 1:211 ESSEX ST STE 106
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-3244
Practice Address - Country:US
Practice Address - Phone:347-836-3045
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-04
Last Update Date:2024-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty