Provider Demographics
NPI:1871888222
Name:YABLONOVSKY, BORIS
Entity type:Individual
Prefix:MR
First Name:BORIS
Middle Name:
Last Name:YABLONOVSKY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 HARVARD AVE
Mailing Address - Street 2:
Mailing Address - City:ALLSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02134-2702
Mailing Address - Country:US
Mailing Address - Phone:617-254-2210
Mailing Address - Fax:617-787-1688
Practice Address - Street 1:121 HARVARD AVE
Practice Address - Street 2:
Practice Address - City:ALLSTON
Practice Address - State:MA
Practice Address - Zip Code:02134-2702
Practice Address - Country:US
Practice Address - Phone:617-254-2210
Practice Address - Fax:617-787-1688
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-14
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care