Individual
DMITRIY FUZAYLOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9701 66TH AVE, REGO PARK, NY 11374-4245
(718) 275-5200
(718) 275-6864
Mailing address
9701 66TH AVE, REGO PARK, NY 11374-4245
(718) 275-5200
(718) 275-6864
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
241269
NY
207LP2900X
Pain Medicine (Anesthesiology) Physician
MD436995
PA
208100000X
Physical Medicine & Rehabilitation Physician
241269
NY
Other
Enumeration date
06/05/2008
Last updated
10/17/2014
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