Individual
MRS. YELENA LAKHCHAKOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
9785 QUEENS BLVD, REGO PARK, NY 11374-3319
(718) 261-9100
(718) 261-6483
Mailing address
9785 QUEENS BLVD, REGO PARK, NY 11374-3319
(718) 261-9100
(718) 261-6483
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
007335
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007335
LICENSE
NY
Enumeration date
03/05/2009
Last updated
02/04/2021
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