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Individual

YURIY YAKUBOVICH TAKHALOV

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
285 SILLS RD STE B, EAST PATCHOGUE, NY 11772-4869
(631) 654-4577
(631) 654-3391
Mailing address
285 SILLS RD STE B, EAST PATCHOGUE, NY 11772-4869
(631) 654-4577
(631) 654-3391

Taxonomy

Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
25MA09904100
NJ
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
271400
NY
207RP1001X
Pulmonary Disease Physician
25MA09904100
NJ
207RP1001X
Pulmonary Disease Physician
Primary
271400
NY

Other

Enumeration date
03/27/2010
Last updated
02/28/2024
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