Individual
DMITRIY YUSUPOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2510 30TH AVE, MOUNT SINAI HOSPITAL OF QUEENS, LONG ISLAND CITY, NY 11102-2448
(718) 932-1000
Mailing address
2510 30TH AVE, LONG ISLAND CITY, NY 11102-2448
(718) 932-1000
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
012020
NY
Other
Enumeration date
08/27/2007
Last updated
08/07/2013
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