Provider Demographics
NPI:1134916950
Name:YHAKUBOVICH, ABRAHAM (LBA)
Entity type:Individual
Prefix:
First Name:ABRAHAM
Middle Name:
Last Name:YHAKUBOVICH
Suffix:
Gender:
Credentials:LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1636 COLEMAN ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-4311
Mailing Address - Country:US
Mailing Address - Phone:347-208-4521
Mailing Address - Fax:
Practice Address - Street 1:1739 OCEAN AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-5402
Practice Address - Country:US
Practice Address - Phone:347-208-4521
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-23
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004234103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst