Fuzaylov, Yakov

Fuzaylov, Yakov is an sole proprietor health care provider with primary practice located at 7835B Spring Field Blvd , Oakland Gardens NY 11364. He recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / General Practice. Dental Providers / Dentist is his primary health care specialty. Fuzaylov, Yakov can be contacted via phone (718) 470-2320.

Contact Information

Primary practice address
7835B Spring Field Blvd Oakland Gardens NY 11364
Phone: (718) 470-2320
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 055027 New York
Dental Providers / General Practice 1223G0001X 50055027 New York

Profile Details

NPI number 1043524200
LBN Legal business name Fuzaylov, Yakov
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 29th, 2010
Last updated Dec 13th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1043524200 NPPES
New York MEDICAID 03271583

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