Provider Demographics
NPI:1184863425
Name:PINKHASOVA, YELENA (PT)
Entity Type:Individual
Prefix:
First Name:YELENA
Middle Name:
Last Name:PINKHASOVA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6360 98TH ST APT B12
Mailing Address - Street 2:
Mailing Address - City:REGO PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11374-2219
Mailing Address - Country:US
Mailing Address - Phone:347-247-8845
Mailing Address - Fax:
Practice Address - Street 1:6360 98TH ST APT B12
Practice Address - Street 2:
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-2219
Practice Address - Country:US
Practice Address - Phone:347-247-8845
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-10
Last Update Date:2009-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022456225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist