Individual
EDEN YAGHOUBI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6010 BAY PKWY, BROOKLYN, NY 11204-6079
(718) 283-6199
Mailing address
11 W END AVE, GREAT NECK, NY 11023-1221
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
020712
NY
Other
Enumeration date
03/27/2017
Last updated
09/08/2022
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