Organization
SIOMS FOREST HILLS MANAGEMENT LLC
Active
Organization
SIOMS FOREST HILLS MANAGEMENT LLC
Active
Parent organization
SIOMS FOREST HILLS
Other names
SIOMS Forest Hills
Organization subpart
Yes
Provider details
NPI number
Legal business name
SIOMS FOREST HILLS
Authorized official
STEVE YUSUPOV MD, DDS (MANAGING PARTNER)
(718) 261-2790
Entity
Organization
Contact information
Practice address
7009 AUSTIN ST STE 201, FOREST HILLS, NY 11375-1012
(718) 261-2790
Mailing address
7009 AUSTIN ST STE 201, FOREST HILLS, NY 11375-1012
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03766474
—
NY
Enumeration date
01/27/2020
Last updated
01/27/2020
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