Individual
IGOR KUSAYEV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9002 QUEENS BLVD, ELMHURST, NY 11373
(718) 558-1000
Mailing address
PO BOX 7096, STOCKTON, CA 95267-0096
(209) 956-7725
(209) 956-7733
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
220339
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02143346
—
NY
01
—
P00459556
RAILROAD MEDICARE
CA
Enumeration date
06/10/2006
Last updated
12/07/2010
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