Provider Demographics
NPI:1174768527
Name:YABLOCHNIKOVA, FAINA (MD)
Entity type:Individual
Prefix:DR
First Name:FAINA
Middle Name:
Last Name:YABLOCHNIKOVA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1382 E 72ND ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-5802
Mailing Address - Country:US
Mailing Address - Phone:718-444-0239
Mailing Address - Fax:
Practice Address - Street 1:3380 NOSTRAND AVE APT 1E
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-4032
Practice Address - Country:US
Practice Address - Phone:347-792-6916
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-12
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2595192084P0800X, 283Q00000X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No283Q00000XHospitalsPsychiatric Hospital