Individual
ARTEM YUSUPOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
AUD
Contact information
Practice address
10825 72ND AVE, STE 1A, FOREST HILLS, NY 11375-7831
(718) 480-8556
(347) 561-9513
Mailing address
10825 72ND AVE, STE 1A, FOREST HILLS, NY 11375-7831
(347) 561-9535
(347) 561-9513
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
00255881
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002588-1
NYS AUDIOLOGY LICENSE
NY
05
—
04407801
—
NY
01
—
1134597701
GROUP NPI
NY
01
—
A100146813
SOLO MEDICARE PTAN
NY
01
—
A400146814
GROUP MEDICARE PTAN
NY
Enumeration date
04/23/2016
Last updated
03/17/2025
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