Provider Demographics
NPI:1942487624
Name:ARABOV, YURY
Entity Type:Individual
Prefix:
First Name:YURY
Middle Name:
Last Name:ARABOV
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 VILLAGE SQ STE 130
Mailing Address - Street 2:
Mailing Address - City:GLEN COVE
Mailing Address - State:NY
Mailing Address - Zip Code:11542-2669
Mailing Address - Country:US
Mailing Address - Phone:516-201-2820
Mailing Address - Fax:516-676-7401
Practice Address - Street 1:100 VILLAGE SQ STE 130
Practice Address - Street 2:
Practice Address - City:GLEN COVE
Practice Address - State:NY
Practice Address - Zip Code:11542-2669
Practice Address - Country:US
Practice Address - Phone:516-201-2820
Practice Address - Fax:516-201-0819
Is Sole Proprietor?:No
Enumeration Date:2008-01-25
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY046301183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist