Individual
GABRIEL YAKUBOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPA-C
Contact information
Practice address
15018 72ND DR, #2F, FLUSHING, NY 11367-2678
(917) 302-5478
Mailing address
15018 72ND DR, #2F, FLUSHING, NY 11367-2678
(917) 302-5478
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
014691-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PRS0194467292
TIRF REMS
NY
Enumeration date
06/10/2013
Last updated
11/30/2015
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