Individual
ARTEM YUSUPOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
AUD
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
Update your record
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