Provider Demographics
NPI:1699928465
Name:SIMKHAYEV, YAKOV (DPT)
Entity type:Individual
Prefix:
First Name:YAKOV
Middle Name:
Last Name:SIMKHAYEV
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7160 YELLOWSTONE BLVD
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-4114
Mailing Address - Country:US
Mailing Address - Phone:718-268-2888
Mailing Address - Fax:718-268-2889
Practice Address - Street 1:7160 YELLOWSTONE BLVD
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375
Practice Address - Country:US
Practice Address - Phone:718-268-2888
Practice Address - Fax:718-268-2889
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-24
Last Update Date:2018-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY303151225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist