Provider Demographics
NPI:1306070834
Name:YABLOK, EPHRAIM TZIYON (MS, PT, DPT)
Entity type:Individual
Prefix:
First Name:EPHRAIM
Middle Name:TZIYON
Last Name:YABLOK
Suffix:
Gender:M
Credentials:MS, PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 VIRGINIA AVE
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07012-1224
Mailing Address - Country:US
Mailing Address - Phone:973-777-0833
Mailing Address - Fax:
Practice Address - Street 1:95 VIRGINIA AVE
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:NJ
Practice Address - Zip Code:07012-1224
Practice Address - Country:US
Practice Address - Phone:973-777-0833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-12
Last Update Date:2009-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024326-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist