Basic Information
| Provider Information | |||||||||
| NPI: | 1154501641 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | BABAYEVA | ||||||||
| FirstName: | YAEL | ||||||||
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| Credential: | P.T. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9918 66TH AVE | ||||||||
| Address2: | APT 3G | ||||||||
| City: | REGO PARK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 113743661 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7183504908 | ||||||||
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| Practice Location | |||||||||
| Address1: | 6260 108TH ST STE 1J | ||||||||
| Address2: | |||||||||
| City: | FOREST HILLS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 113751301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7182752224 | ||||||||
| FaxNumber: | 7182755100 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/13/2007 | ||||||||
| LastUpdateDate: | 11/13/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 020982 | NY | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.